Contracts Specialist (Provider Network Contracting) in Woburn, MA at Beacon Health Options

Date Posted: 11/16/2019

Job Snapshot

Job Description

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a ‘world-class’ candidate experience from the moment you click ‘Apply’! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Contracts Specialist to join our team at our Woburn, MA office.  The Contracts Specialist identifies and recruits physicians, providers and medical to fulfill Beacon network needs.

What does a typical day look like?

  1. Primarily negotiates professional rates and contract terms with both new and contracted providers.
  2. In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network.
  3. 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.
  4. Leverages a variety of tools (e.g., geo-access, customer requests, published provider directories) to identify and pursue provider recruitment to close network gaps.
  5. Identifies opportunities for cost savings and process improvements related to the contracting process.
  6. For assigned contracts reviews, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider services agreement.
  7. Ensures that Contract Language is in compliance with plan agreements and within all state and federal regulatory and NCQA standards.
  8. Gather, review and submit credentialing applications, as required, for network development and management.
  9. Provides general support to all network development activities and support Director and other Contract team with implementation requirements.
  10. Strategizes with other members of the management team to ensure access and availability of providers meets current standards.
  11. Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.
  12. 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
  13. Adheres to all Beacon policies and procedures and standards of operations.
  14. Performs special projects and other duties as assigned and required.

What you Contribute?

Education: High school diploma or GED required. Bachelor’s Degree in Business, Finance or Health Care Management preferred.

Licensure: N/A

Knowledge, Skills & Abilities:

  • 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

Shift: Monday – Friday 8:30am-5:00pm

What Makes Us Different?

  • Here, it’s not just a job – it’s an opportunity to change lives.
  • Our employees are learners, innovators and original thinkers.
  • Our mission and values guide the way we treat our members, providers and each other.

What We Have to Offer:

  • Healthcare benefits available starting day 1!
  • Health & wellbeing incentives, such as gym membership reimbursement
  • 401K with company match to help reach your future financial goals
  • Generous PTO, because we know life happens outside of work
  • Tuition reimbursement so you can keep reaching your fullest potential

If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

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

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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