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Manager, Provider Partnerships - Los Angeles, Ca

Company Name:
ValueOptions, Inc., a Beacon Health Options company
ValueOptions, Inc., a Beacon Health Options company
Manager, Provider Partnerships - Los Angeles, CA
ValueOptions 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.
Position Location: CA - Cypress
AAP Reporting Location:
ID: 33119
Job Family: Account Management
Functional Area: ADMINISTRATION
FTE Status:
Scheduled Weekly Work Hrs: 40
Workday Schedule: Weekdays Only
Workday Start Time: 800
Workday End Time: 1600
Variable Work Schedule:
Manager, Provider Partnerships - Los Angeles, CA
Job Description
Build highly collaborative relationships with providers, drive provider performance improvement year-over-year through education and data, and identify top-performing providers for innovative programs/pilots
Outcomes
Generate net promoter score (NPS) from providers of +30% by the end of year one (NPS is a tool to measure satisfaction; more about NPS can be found here: )
Craft strategic plans for 50% of providers in territory within 6 months and 100% within 9 months
Identify both top 10 highest performing and top 10 biggest under-performing providers in territory, using provider profiler data, by end of month 3
Improve health outcomes of members by reducing hospital re-admission rate by 25 bps per year and increasing community tenure of members by 10 bps per year, beginning in month 6
Provide quarterly written summary of provider performance and network operational needs
Maintain a 3-month response time for 95% of provider queries, as measured from a daily activity log
Beginning in month 6, identify 1 provider candidate each year to join Beacon's Provider Advisory Council
Identify two "A" players to join Beacon annually
The Manager of Provider Partnerships is primarily responsible for interfacing with a strategic subset of Beacon's network of community providers. Beacon is looking for strategically oriented professionals to 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 will be 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 the value that each provider is delivering to Beacon members, with a focus on driving high levels of value for Beacon members.
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.
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 will report to the Account Management in the region, with dotted line responsibility to the corporate Provider Partnerships department, where centralized training, coaching, and data analysis reside.
Responsibilities
1. Serve as direct contact point for a subset of Beacon providers, generally the largest and/or most important in a specific region, and be the "face" of Beacon for those providers
2. Serve as a "concierge" for strategic 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
3. Serve the same "concierge" role for any direct provider query or request, even for those outside of the strategic designation, to ensure there is "no wrong door" for a provider to access assistance from Beacon
4. Lead meetings with strategic providers, to include set number of meetings per provider, per year
5. 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
6. Maintain accountability for the monitoring and interpretation of provider utilization data, to include overseeing data analysis to understand root cause of any outlier utilization and engaging providers to discuss and help remedy outlier utilization; for clinical issues, surface issues to Beacon's local or service center clinical teams and participate in helping to address concerns
7. With Account Managers, craft annual strategic plan for each strategic provider partner with measurable goals for each calendar year
8. Work with Account Management team to ensure provider activities are in line with Beacon priorities
9. Liaises 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
10. Identifies innovative provider programs and gathers information on program structure, function, efficacy and outcomes to share with Beacon innovation warehouse
11. Solicits annual feedback from providers regarding Beacon partnership and prepares annual regional report on regional provider perspectives
12. With Account Managers, shares health plan-specific provider performance to educate health plan clients about provider performance, with a focus on utilization outliers
13. With Corporate Provider Partnerships department, help identify opportunities for innovative pilot programs, to include program development, implementation, launch, and efficacy and outcomes measurements
14. Assist with provider orientations and provider training events in the region; trainings and orientations will be led by Beacon's network operations team
15. 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
16. Provide input into rate increase evaluation process led by network operations
17. Other duties and projects as assigned and specified by supervisor in line with Department and company needs
Beacon anticipates the Manager of Provider Partnerships will spend time each week in four main ways:
On-site provider outreach, via scheduled meetings (1-2 days/week)
Analyze provider data to determine utilization and outcomes outliers, including root cause analysis for outliers ( 1 day/week)
Developing strategy for specific provider engagement activities to be executed (1-2 days/week)
PowerPoint report generation to prepare for on-site provider outreach meetings ( 1 day/week)
Qualifications
Master's degree in Behavioral Health required.
Independently licensed behavioral health clinicians strongly considered.
Professional demeanor, strong written and oral communication skills needed.
Knowledge of managed care, analytics, performance improvement and clinical skill preferred.Strong execution and follow-up skills, analytic skills, ability to multi-task are key.
PI91495505

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