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Network Contract Manager - Managed Care Contracting in Woburn, MA at Beacon Health Options

Date Posted: 12/18/2018

Job Snapshot

Job Description

ABOUT THE POSITION

The Manager of Network Development & Contracting in Woburn, MA leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization.The position is responsible for network development, 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 agreements, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and ensuring rates negotiated are within established guidelines.

Position Responsibilities:

  • Negotiate rates and contract terms with currently 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.
  • Perform reimbursement analysis on providers that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.
  • Identify opportunities for cost savings and process improvements related to the contracting process.
  • Review and draft suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.
  • Participate in provider meetings, trainings.
  • Ensure that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.
  • Participate in provider network Continuous Quality Improvement activities.
  • Provide general support to all network development activities.
  • Strategize with and other members of the management team and client/plan to ensure access and availability of providers meets current standards
  • Collaborate with other departments to address and resolve operational issues as related to negotiated contract language.
  • Act as network liaison to client health plans with onsite presence as needed.
  • Other duties as assigned and specified by supervisor in line with Department and company needs. 

Position Requirements:

Education : Bachelor’s Degree

Relevant Work Experience:

  • MS Office – 3 years
  • Rate & Contract Language Negotiation – 3 years
  • Project Management – 1-2 years
  • Analytics – 1-2 years

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