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PROVIDER RELATIONS MANAGER I in Little Rock, AR at Beacon Health Options

Date Posted: 2/28/2019

Job Snapshot

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Provider Relations Manager to join our team in Little Rock, AR.  The Provider Relations Manager will cultivate, maintain and strengthening provider relationships for a growing a 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 Requirements:

  • 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:

    1. Claims and service recovery

    2. Program benefits

    3. Clinical initiatives

    4. Referral and authorization

    5. Regulatory compliance

    6. Billing and payments

    7. 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.

Other Job Functions

  • Maintain professional growth and development through self-directed learning activities.

  • Adhere to all Beacon policies and procedures and standards of operations.

  • Complete all required and assigned trainings.

  • Attend all mandatory company or department meetings.

  • Display a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.

  • Act as a mentor to junior team members; leading by example and 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.

  • Ensure compliance with regulatory and NCQA requirements.

Education:     Bachelor’s Degree in business administration or health related field preferred and or equivalent work experience. 

Licensures:    None

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

  • 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 on

  • Must be able to travel within an assigned territory on a daily basis

Knowledge, Skills & Abilities:

  • Proficient in word suite

  • Excellent written and verbal communication skills

  • Problem solving skills

  • Excellent analytical skills

TO APPLY

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

Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

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