Managed Care Analyst

At Beacon Behavioral Partners, we are dedicated to transforming behavioral health care through innovation, compassion, and operational excellence. As a rapidly growing organization serving diverse communities, Beacon is committed to building a collaborative culture where every team member plays a vital role in advancing our mission.

Join us as we expand our impact and invest in talent that drives meaningful change. If you're passionate about making a difference and thrive in a dynamic, purpose-driven environment, explore our latest opportunity to become part of the Beacon team.

Position Summary :

Perform a variety of analytical, administrative and payer relations tasks to support Beacon's Managed Care Contracting, Payer Relations, Credentialing, Revenue Cycle, Operations Management, and Compliance teams related to the management of payer agreements, contracts and associated fee schedules.

Duties and Responsibilities-Contract Management :

• Reports quarterly on activities related to revenue cycle analysis and operational impact.
• Provides analyses and review of managed care contracts and payment, including information from Revenue Cycle and Finance.
• Perform analyses and creates reports to support negotiates and assess health plan performance.
• Performs comparisons of rates across geographies and market benchmarks to support contract negotiations.
• Provides analyses of health plan contracts and rates for due diligence of potential partners.
• Outreach to payers to ensure all agreements are set up accurately and kept up-to-date in Beacon's internal systems for including Medicare, Medicaid, Tricare, Commercial, etc.
• Evaluate health plan credentialing and provider enrollment efficiency, report out routinely.
• Ongoing analysis and reporting of managed care market / market share, market pricing and monitoring of payer contract performance.
• Maintains payer fee schedules and rates in Beacon's internal systems.
• Access payer portals as needed to obtain rate and contract information.
• Assists with payer relations activities including disputes over medical necessity of services, denial management, and payment of services.
• Assists with managing relationships with managed care organizations, employers, third party payers, Medicare, and Medicaid on behalf of Beacon.
• Conducts payer outreach to address denials related to contracting or credentialing issues.
• Performs other work-related duties as assigned.

Education

High school diploma require, and college degree preferred.

Skills / Experience

Required

Preferred