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Health Care in San Andreas,California
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Contract Development Manager

Beacon Health Options Remote Full-Time
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ABOUT THE POSITION

The Contract Development Manager leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization. *This is a remote position*.  The position is responsible for network development, recruiting for new business, contracting, and rate negotiations for their assigned territory.  Duties include identifying and contracting new/ re-contracting existing providers around Beacon’s need for services, negotiating rates, drafting provider services and facility agreements, sending and receiving credentialing applications, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and reports and ensuring rates negotiated are within established guidelines.

Position Responsibilities:

  • Negotiates rates and contract terms with currently contracted providers and facilities.
  • In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.
  • Performs reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.
  • Identifies opportunities for cost savings and process improvements related to the contracting process.
  • Review, 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 with implementation requirements.
  • Strategizes with other members of the management team and client/plan 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 reports and analyze data as directed by the Director of Provider Relations or other members of the management team.
  • 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.

Position Requirements:

Education: High School diploma or GED required.  Bachelor’s degree preferred.

Relevant Work Experience:

  • At least 3 years’ experience rate & contract language negotiation to include facility and higher level of care experience; In-depth knowledge of provider 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.
  • 2 (two) years of provider contracting, provider relations or similar experience.

To Apply:

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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

$REM

 

Skills required

Business Development
Negotiation
Provide Service
Customer Retention
Utilize Passion
Develop Opportunity

Location

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Contract Development Manager
Business Development Director
Estimated Salary: $120K
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Job ID: 56764

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Beacon Health Options (Beacon) combines two of the country’s most prominent behavioral health companies – Beacon Health Strategies and ValueOptions. Together we serve more than 45 million people across all 50 states and the United Kingdom.

We began as two companies with one common mission: helping people live life to the fullest potential.

Today, we are Beacon Health Options – providing best-in-class behavioral health solutions for regional and specialty health plans; employers and labor organizations; and federal, state and local governments. Beacon offers superior clinical mental health and substance use disorder management, a strong employee assistance program, work/life support, specialty programs for autism and depression and insightful analytics to improve the delivery of care.