Director Contract Development in Providence, RI at Beacon Health Options

Date Posted: 2/5/2020

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 Director, Contracting Development a highly organized and compassionate professional to join our team at our Woburn, MA offices.  The Director, Contracting Development is a highly visible both internally and externally, leader of their assigned market. This person leads a team that is accountable for the network development and contract management activities for a growing and complex managed behavioral health care organization. This role is regionally focused with oversight of network for existing clients as well as recruiting for new business - including contracting and rate negotiations for their assigned territory.  The Director, Contract Development supports and executes provider strategy as set forth by Market and Regional leadership, leveraging the organization’s matrix structure to engage and coordinate support cross-functionally among key stakeholders. This person is an SME and thought leader in network operations, fee schedules and reimbursement methodologies.

What does a typical day look like?

  1. Manage a regional contracting team, ensuring day-to-day work is performed effectively and aligns with larger strategic objectives within the department and across the region, including financial targets.
  2. Lead regional contracting team in support of internal and external stakeholders, to successfully secure executed agreements that enhance access for Beacon Members, improves quality care and is in-line with the overall success of Beacon for all assigned books of business in assigned market (Medicaid, Commercial, and Medicare).
  3. Serve as escalation contact for Regional Leadership on provider contracting issues.
  4. Validate accuracy reimbursement analysis on providers/facilities as required for contract negotiations, performance and departmental reports as they impact their assigned market/region.
  5. Be the SME in reimbursement methodologies and thought leader within Beacon for DRGs, FFS, RVRBS, APCs, Per Diem, Case Rate and VBP, CPT and HCPC codes as they relate to contracting system payment configuration and claims payment.
  6. Identify opportunities for cost savings and process improvements related to the contracting process.
  7. Ensure compliance with Beacon standards and best practices throughout contracting process, and oversee resolution of all proposed changes to provider services agreements.
  8. Monitor Contract Language on all regional/market products, ensuring compliance with plan agreements and that Contracts are kept current within all state, federal and NCQA standards.
  9. Prepare reports and analyze data as requested by the Regional VP and other company or departmental leaders.
  10. Collaborate with Network Strategy leadership to execute on process improvement initiatives related to provider satisfaction impacts and root cause of issues, to achieve shorter provider inquiry response times and increase provider satisfaction.
  11. Develop strong provider relationships built on trust and collaboration. Manage and balance Beacon stakeholder and provider expectations.
  12. Oversee coordination of practitioner and facility orientation and training.
  13. Support transition of new business to ongoing operations in collaboration with other Beacon teams and departments.
  14. Collaborate with the Quality and Legal Departments to perform complaint and grievance resolution and communication.

What you Contribute?

Education: Bachelor’s Degree required; Master’s Degree preferred.

Licensure: N/A

Knowledge, Skills & Abilities:

  • Minimum 5-8 Years of work experience with direct experience in

Contracting or similar managed care roles that includes rate & contract language negotiation and network operations.

  • In-depth knowledge and experience in provider reimbursement methodologies. Well versed in Medicaid and Medicare program managed regulations for assigned market.

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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