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Contract Specialist in Little Rock, AR at Beacon Health Options

Date Posted: 12/5/2018

Job Snapshot

Job Description

ABOUT THE POSITION

The Contract Specialist identifies and recruits Physicians, providers and Medical Groups to fulfill Beacon network needs.

Position Responsibilities:

  • 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.

Position Requirements:

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.

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