Network Manager in Colorado Springs, CO at Beacon Health Options

Date Posted: 7/7/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Network Manager to join our team at our office in Colorado Springs, CO.  The Network Manager will be responsible for leading all territory network development and contract management activities for the Crisis Services Program.   The position is responsible for network development, recruiting for new business, contracting, and rate negotiations for Crisis Services in Colorado.  Duties include identifying and contracting new/ re-contracting existing providers around Beacon’s need for Crisis Services, negotiating rates, drafting provider services and facility agreements, sending and receiving credentialing applications, overseeing the resolution of language changes and securing executed contracts with providers, developing recruitment plans and reports and ensuring rates negotiated are within established guidelines.

Position Responsibilities:

  • Negotiates rates and contract terms with Crisis Services providers and facilities.
  • In conjunction with internal and external stakeholders, secure executed agreements with identified out of network Crisis Services providers for inclusion in the Beacon Health network.
  • Performs reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.
  • Identifies opportunities for cost savings and process improvements related to the contracting process.
  • Review, draft and document suggested language changes, and oversee resolution of all proposed changes to the provider Crisis 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 the Crisis Services Program Director with implementation requirements.
  • Strategizes with other members of the management team and client/plan to ensure access and availability of Crisis Services providers meets current standards.
  • Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.
  • Prepares reports and analyze data as directed by the Crisis Services Program Director or other members of the management team.

Position Requirements:

Education: Bachelor’s degree or equivalent experience in health care field required. Master’s Degree in health care related field preferred.

Licensure: Valid State Driver‘s License Required

Relevant Work Experience:  

  • At least 3 years’ experience rate & contract language negotiation to include facility and higher level of care experience; In-depth knowledge of all facility, and some provider 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.

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

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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