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Director of Contract Development
Beacon Health Options • US-Nationwide
Posted 27 days ago
ABOUT THE POSITION
We are currently seeking a dynamic Contract Development Manager to join our team at our office in Coral Gables, FL or to work remotely. The Contract Development Manager will be responsible for the network development and contract management activities for a growing and complex managed behavioral health care organization. The position is responsible for network development, recruiting for new business, contracting, and rate negotiations for their assigned territory. In addition, this position supports and executes provider strategy for existing business as set forth Market and Regional leadership. The role is regionally focused with oversight of network for existing clients, navigates Beacon’s matrix structure to engage, and coordinates and supports cross-functional Beacon stakeholders. They are expected to be a thought leader in network operations, fee schedules, and reimbursement methodologies.
- Leads a contracting team that leads the development and execution of network strategic plans that support are part of the various components of a winning Network strategic plan that establishes Beacon Health Options as leader in the behavioral health space. Is directly responsible for the contract strategic component that integrates the various other mission critical components of the overall Network Strategy of their assigned market/territory.
- Is accountable to lead your department in support internal and external stakeholders, to successfully secure executed agreements that enhance access for Beacon Members, improves quality care and is in-line with the overall success of Beacon for all assigned books of business in assigned market to include Medicaid, Commercial, and Medicare books of business.
- Validates for accuracy reimbursement analysis on providers/facilities as required for contract negotiations or other performance reports, department reports as they impact their assigned market/region.
- Is well versed in all aspect of reimbursement methodologies and is considered a thought leader to internal departments in Beacon for DRGs, FFS, RVRBS, APCs, Per Diem, Case Rate and VBP, CPT and HCPC codes as it relates to contracting system payment configuration and claims payment.
- Is well versed in Medicaid and Medicare program managed regulations for assigned market and has a team that is similar capable and up-to-date on relevant managed care regulations for their market.
- Identifies opportunities for cost savings and process improvements related to the contracting process.
- Directs provider contracting staff to assure day-to-day activities are performed effectively and support the assigned market network strategy, including meeting financial targets.
- Ensures that departments properly reviews, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider services agreement, secures appropriate internal approval on finalized changes, that are in-line with Beacon standards.
- Ensures that Contract Language for products in their region/market is in compliance with plan agreements and within all state and federal regulatory and NCQA standards and kept updated.
- Prepares reports and analyze data as directed by the Region AVP of Contracting or other members of the management team in the Network Department
- Direct Contracting staff to assure day-to-day activities are performed effectively and support the Region’s network strategy, including meeting financial targets.
- In collaboration with Network Management Leadership, execute on a process improvement strategy which identifies provider satisfaction impacts and root cause of issues to achieve shorter provider inquiry response times, improved employee engagement, and higher provider satisfaction.
- Support and participate in the Network Management Department’s process improvement and transformational initiatives to drive completion and successful outcomes.
- Assure the Contracting team is accountable to Network Management Leadership, Corporate Operations, and Regional Teams by meeting internal and external performance standards and guarantees.
- Develop strong provider relationships built on trust and collaboration. Manage and balance Beacon and provider expectations.
- Oversee coordination of practitioner and facility orientation and training.
- Collaborate with the Quality and Legal Departments to perform complaint and grievance resolution and communication.
Education: Bachelor’s Degree required. Master’s Degree preferred.
Relevant Work Experience:
- Minimum 5-8 Years of work experience with direct experience in Contracting or similar managed care roles that includes rate & contract language negotiation and network operations.
- In-depth knowledge and experience in provider reimbursement methodologies.
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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.