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Network EAP Manager in Morrisville, NC at Beacon Health Options

Date Posted: 11/26/2018

Job Snapshot

Job Description

About The Position:

The Network EAP Manager coordinates directly with key commercial customers with on-site EAPs or EAP employees to understand network access gaps and member/dependents network preferences with the goal of coordinating and resolving any access pain points. The Network EAP Manger leads all territory network development and contract management activities for a growing and complex managed behavioral health care organization

Position Responsibilities:

  • Coordinates directly with customers (e.g., benefits managers, on-site EAPs) to understand individual customer access gaps and member preferences to strengthen the network composition and inform recruitment efforts
  • Develops client-facing reports and executive summaries of actions taken to assure compliance with performance guarantees
  • Coordinates with account management and sales/growth staff to improve client satisfaction with network access and adequacy
  • Communicates with clients and other key Beacon Health Options staff (network, contracting, account management, customer services) regarding network access needs and strategies that positively differentiates  Beacon Health Options  related to access (e.g., telehealth)
  • Serves a liaison between clients and network recruitment and operations staff to improve processes and outcomes that impact access
  • Connects key providers that meet the member preferences and/or needs of targeted customers (eg., employers) with on-site EAP staff to increase awareness and referrals to preferred access providers
  • Serves as a liaison between the account management and network teams to assure follow-through on network gap closure to meet and exceed customer performance guarantees
  • Maintains database of EAP clients that includes on-site EAP contacts, client details to guide recruitment (e.g., geography, member locations, cultural preferences) and to track access needs and gaps (e.g., Hindu-speaking providers, substance use specialists, etc).
  • Coordinates access escalations with account management, network teams, clinical/customer service and client benefit or EAP staff to close immediate gap, developing ongoing solutions to eliminate future escalations.
  • Strategizes with other members of the management team to ensure access and availability of 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 Director of Contracting or other members of the management team.
  • Adheres to all Beacon policies and procedures and standards of operations.
  • Completes all required and assigned trainings.
  • Attends all mandatory company or department meetings.
  • Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.
  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  • Acts as a mentor to junior team members by leading by example and guiding 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.

Position Requirements:

  • Education: High School diploma required.  Bachelor’s degree preferred or equivalent experience in health care field.

Relevant Work Experience: 

  • Minimum of 2-3 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

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