Network Contract Manager- Telecommuter

Date Posted: 02/13/2020

Equity Staffing is searching for Healthcare Network Contract Managers for Telecommute/Remote work. This is a contract position with a Fortune 100 organization. Our client serves more than 85 million people and has a reputation for bold ideas. If you enjoy working with energetic people in a collaborative environment, we want to speak with you!
Description:

This will be a telecommuter opportunity that will focus on outpatient behavioral health provider recruitment and contracting for Medicaid, commercial and Medicare products. Position works on contract amendments; review and analyze and make recommendations regarding provider reimbursement increase requests; and investigates provider questions about existing contract. As appropriate, position investigates internal questions about provider contracts, rates and related matters. Position will attend and as appropriate participate in webex conference calls regarding new products and markets, provider recruitment and expansion of outpatient behavioral health network in Western U.S. The position will possibly involve some travel for provider recruitment. Most provider interaction will be telephonically or electronically through the docu-sign and salesforce applications.

Specific Duties:

1. Provider overall assistance in developing or expanding outpatient behavioral health provider network

2. Maintain documentation of provider recruitment effort in all applicable systems

3. Provider outreach follow-up for network development or expansion both telephonically and email

4. Provider contracting and contract amendments through provider interacting both telephonically, email and computer systems

5. Analyze provider fee schedules, analyze provider reimbursement increase requests and make recommendations

6. Manage services issues related to provider data updates following protocols

Specific Tasks:

• Make follow up outreach via phone or email to network providers or prospective providers

• Document/entering data updates through the Salesforce application

• As an integral part of the recruitment efforts, review and process returned documents

• Collect all contracting and credentialing information from providers for credentialing purposes

• Submit applications/contracts/credentialing for processing

• Document with entering recruitment data updates through the Salesforce application

• Send contracting information to providers

• Submit provider updates through the ePuf application system following protocol

• Weekly follow up with provider related to needed information for provider recruitment

• Prepare provider contracts and amendments

• Send provider contracts for signature via Docusign

• Review and analyze provider reimbursement increase requests using Fiscal Analysis Tool spreadsheet and make recommendations to Western Region Director

Qualifications/Experience:

1. Assess and interpret customer needs and requirements with providers and staff

2. Ability to solve moderately complex problems and conduct moderately complex analysis

3. Perform work with minimal guidance to meet timelines

4. Experience working with behavioral health providers preferred

5. Min. undergraduate degree or equivalent

6. Prior health plan experience in provider contracting/provider relations

7. Experience using Microsoft Excel software

8. Experience and ability to analyze provider fee schedules and reimbursement for specific CPT codes quickly and thoroughly.

9. Experience in behavioral health contracting with health plan and/or provider organization

10. Understand health insurance provider contracting

11. Experience with Medicaid and commercial outpatient behavioral health contracting
Equity Staffing Group is one of the fastest growing Native American owned staffing companies in the United States. We are a certified Minority Business Enterprise (MBE) by the National Minority Supplier Development Council (NMSDC) and the Rocky Mountain Minority Supplier Development Council (RMMSDC).

Equity Staffing Group is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Equity Staffing Group will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.

We welcome you to learn more about our company by visiting www.equitystaffing.com.




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Testimonials

"I was so impressed with the outstanding service that Equity Staffing provided in placing me in my current position.  I wasn’t sure I would be a good candidate for this position, but my recruiter and Equity’s Account Manager took the time to go over the job description and how my experience and skill set would fit in perfectly with this job assignment.  I am glad I took their advice, because I am now on contract with a great company working with a professional staff and learning how to support a management team in an industry I have never worked in before.” 

Lisa M.

Denver, CO

“I’ve been an IT contractor for 9 years, and in that time I’ve been exposed to numerous IT staffing firms and consulting agencies, big and small.  Equity impressed me immediately.  My recruiters quickly and efficiently connected me with a great tech company whose needs in both personality and tech proficiency matched my wheelhouse in addition to a healthy dose of career progressing tech challenges.  And a 12 minute drive from my house no less.  That’s huge for me.  They were willing to meet face to face before the client company interview which, in my experience, is critical to the staffing firm / contractor relationship.  Equity is organized, modern, and professional, and my recruiters were very pleasant to work with, responsive, and generous with their time.  I’m grateful for all they’ve done for me.”

Christopher S.

Minneapolis, MN

“Working as a consultant for Equity Staffing Group has been a wonderful experience.  My recruiter was a true professional throughout the entire process.  Equity separates itself from other staffing companies I have worked with in past because they provided wonderful customer service, they had benefits offerings,  the onboarding was easy and efficient but best of all they followed up with me prior to my assignment ending and found my next assignment shortly afterward.  I highly recommend the professionals at Equity Staffing Group!”

Tamika B.

Atlanta, GA

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