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Company Contact Info
- Little Rock, AR
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Beacon Health Options • Little Rock, AR
Posted 11 days ago
ABOUT THE POSITION
The Contract Specialist identifies and recruits Physicians, providers and Medical Groups to fulfill Beacon network needs.
- Primarily negotiates professional rates and contract terms with both new and contracted providers.
- In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.
- Works closely with network Contract Manager and other contract leadership and other staff (e.g., credentialing) to assure client performance guarantees related to network access are met.
- Leverages a variety of tools (e.g., geo-access, customer requests, published provider directories) to identify and pursue provider recruitment to close network gaps.
- Identifies opportunities for cost savings and process improvements related to the contracting process.
- For assigned contracts reviews, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.
- Ensures that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.
- Gather, review and submit credentialing applications, as required, for network development and management.
- Provides general support to all network development activities and support Director and other Contract team with implementation requirements.
- Strategizes with other members of the management team to ensure access and availability of providers meets current standards.
- Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.
- Prepares and submits under the direction of Network leadership required internal requests for system configuration, provider demographic data changes or claims processing in support of assigned market
- Adheres to all Beacon policies and procedures and standards of operations.
- Completes all required and assigned trainings.
- Attends all mandatory company or department meetings.
- Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.
- Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
- Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.
- Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.
- Assist team members and offers suggestions to improve processes, culture, or work environment.
- Performs special projects and other duties as assigned and required.
Education: High School Diploma required. Bachelor’s Degree in Business, Finance or Health Care Management preferred.
Relevant Work Experience:
- Minimum of 2-3 years’ experience in managed care ideally in provider relations, behavioral health organization or similar. Strong understanding of Physician reimbursement methodologies - behavioral health experience a plus.
- Knowledge of managed care contract requirements to include state and federal regulatory requirements for Medicare and Medicaid plans and CMS guidelines.
- Intermediate skill knowledge of electronic health record and electronic medical record software systems; FlexCare, Raintree, Connect preferable.
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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