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Provider Relations Manager in Woburn, MA at Beacon Health Options

Date Posted: 3/18/2019

Job Snapshot

Job Description

ABOUT THE POSITION

The Provider Relations Manager is responsible for cultivating, maintaining and strengthening provider relationships for a growing and complex behavioral health care organization. In this highly visible field position, the provider relations manager acts as the primary liaison between Beacon and its providers including facilities, groups, FQHCs and individual practitioners.  Key responsibilities include establishing positive working relationships with providers, resolving provider inquiries and navigating the nuances of each market, including regulatory requirements for each state.  Provider Relations Manager works directly with providers, clients and internal departments including network development, network operations, account management, member services, clinical operations and claims administration. Represents Beacon in various venues including provider events.    

Position Responsibilities:

  • Act as the primary liaison between the provider community and Beacon ensuring all provider needs and concerns are addressed and answered.
  • Conduct regular outreach and onsite operations visits to provider sites. Visits may include presentations, staff educations, provider orientations, and appreciation events.
  • Take ownership of the provider’s experience with Beacon and facilitate problem resolution as appropriate and necessary.
  • Work with provider data and credentialing team members to support provider enrollment, provider data integrity and re-credentialing efforts.
  • Work collaboratively with Network Development and Contracting staff to ensure an adequate and appropriate provider network. Participate in contracting strategy discussions around potential recruitment opportunities.
  • Coordinate with regional provider operations, operations pod and clinical teams to support regional objectives and client needs.
  • Facilitate and lead orientation meetings and communication sessions with key providers on Beacon’s policies related to:
    • Claims and service recovery
    • Program benefits
    • Clinical initiatives
    • Referral and authorization
    • Regulatory compliance
    • Billing and payments
    • Complaints and appeals
  • Plan and facilitate trainings using various technology solutions, including new applications and procedures.
  • Lead classroom-style training sessions remotely, in-person and via WebEx/video conference.
  • Act as the official department representative for assigned cross-functional workgroups.
  • Lead provider projects as assigned by manager.
  • Build provider support protocols and workflows and continuously look for opportunities for process improvement.
  • Develops and execute strategies to increase electronic transaction rates across networks.
  • Manage and coordinate the production of various reports and requests.
  • Participate in the development of departmental policies, procedures and processes.

Position Requirements:

Education: Bachelor’s degree preferred or equivalent work experience.

Relevant Work Experience:

  • Minimum of 5 years field sales experience or provider relations experience, with a proven track record of establishing, building, and managing accounts/providers preferred.
  • 3-5 years of healthcare industry experience.
  • Must be able to work independently. 
  • Must be highly organized and able to manage multiple accounts at once. 
  • Must be able to write and speak clearly and effectively.
  • Ability to work under pressure.
  • Knowledge of the managed care/ health care industry, Medicaid and Medicare preferred.
  • Demonstrated ability to manage projects from conception through implementation.
  • Must be able to travel within an assigned territory on a daily basis.

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