Manager Provider Partnerships in Woburn, MA at Beacon Health Options

Date Posted: 6/26/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic Manager of Provider Partnerships for our Woburn, MA office! The Manager of Provider Partnerships (MPP), Substance Use is primarily responsible for interfacing with a strategic subset of Beacon’s network of Substance Use providers. MPPs are strategically oriented professionals help lead the next generation of provider engagement, with a focus on leveraging the tremendous amount of data available to providers to help improve the value delivered to Beacon members. The Manager will achieve this by building strategic partnerships and bringing an analytic mindset to discussions with providers.

The Manager is expected to lead analysis of data sets to be able to identify data outliers and opportunities for improvement for individual providers. The Manager will need to build relationships with internal Beacon teams to be successful in this role, in particular coordinating very closely with the clinical team, to ensure high quality care to members, and with the network operations team, to ensure the network team is up-to-date about details concerning each provider. The Manager will then share this strategic data with providers to help educate the provider about Beacon’s mission and vision and the value that each provider is delivering to individuals and families, with a focus on driving high levels of value for Beacon members and delivering on performance on behalf of Beacon’s clients.

The Manager will be responsible for bringing innovative thinking into the provider community in the region, by identifying high-performing providers who may be interested in new and innovative payment or program models, and then working with those providers to implement the new concepts.  Provider innovations reflect Beacon’s thought leadership and success in this position is based on strong communication skills and solid relationships with internal and external stakeholders.

As part of a national network of Managers, Provider Partnerships, the Manager will be responsible for contributing to the best practices of the entire group and for taking best practices and high-quality program ideas/designs into the Manager’s region to drive high levels of value.

The Manager, Substance Use will report to the Director, Provider Quality, in the region.  They will receive support from the corporate Provider Partnerships department, where centralized training, coaching, and data analysis reside.

Beacon anticipates the Manager, Provider Partnerships, will spend time each week in five main ways:

  1. On-site provider outreach, via scheduled meetings (1-2 days/week)
  2. Analyze provider data to determine utilization and outcomes outliers, including root cause analysis for outliers and utilization patterns (~1 day/week)
  3. Developing strategy for specific provider engagement activities to be executed (1-2 days/week)
  4. PowerPoint report generation to prepare for on-site provider outreach meetings (~1 day/week)
  5. Provider specific problem resolution and navigation of Beacon (1/2- 1 day/week)

 Position Responsibilities:

  • Serve as direct contact point for a subset of Beacon Substance Use providers, generally the largest and/or most important in a specific region, and be the “face” of Beacon for those providers, as they need help and access to Beacon, including receiving inbound questions from provider, filtering question to proper internal audience at Beacon, and either facilitate or deliver the responses from the Beacon team back to the provider.
  • Lead meetings with strategic providers, to include a minimum number of meetings per provider, per year, based on relationship with Beacon, performance on metrics and health plan requirements.
  • Analyze strategic provider reports around cost, utilization, and outcomes, and prepare reports to share with providers that detail provider performance over time, highlighting key areas of focus, including monitoring and interpretation of provider utilization data, coordination to understand utilization patterns and efforts to keep data meaningful to providers in a local market; for clinical issues, surface issues to Beacon’s local or service center clinical teams and participate in helping to address concerns.
  • In response to provider data, and in collaboration with Beacon stakeholders, craft annual strategic plan for each strategic provider partner with measurable goals for each calendar year, supporting provider activities consistent with Beacon priorities.
  • Work with Beacon clinical team to be knowledgeable regarding Beacon UM and care management programs and services, to be able to answer or appropriately triage provider questions.
  • Provides summary reports at a provider and regional level supporting delivery of provider activities and supporting increased provider satisfaction throughout the year.
  • Communicate and collaborate with regional leadership to support provider activities consistent with Beacon’s provider strategy and deliver progress to internal and external stakeholders.
  • Identifies current innovative provider programs and gathers information on program structure, function, efficacy and outcomes to share with Beacon colleagues. With Corporate Provider Partnerships department, help identify opportunities for expansion and development of innovative pilot programs, to include program development, implementation, launch, and efficacy and outcomes measurements.
  • Assist with provider orientations and provider training events in the region; trainings and orientations will be led by Beacon’s network operations team.
  • Closely collaborate with Beacon’s network operations team to ensure contracting, credentialing and other network operations are completed within necessary timelines and that there is a fluid bi-directional sharing of information, including input into rate increase evaluation process led by network operations.
  • Support corporate initiatives regarding Value Based Payment (VBP), clinical innovation, and thought leadership transforming provider relationships from transactional interactions to aggregate data.
  • Other duties and projects as assigned and specified by supervisor in line with Department and company needs.

Position Requirements:

  • Education: Master’s degree in Behavioral Health required
  • Licensures: Independently licensed behavioral health clinicians strongly preferred
  • Relevant Work Experience:
    • Background in working with Substance Use; knowledge of current issues within the regional market.
    • Knowledge of managed care, analytics, performance improvement and clinical skill preferred.
    • Strong execution and follow-up skills, analytic skills, organization, and ability to multi-task are key.

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 Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled