BH & IDD PN Contract Manager

LOCATION: Remote - this is a home-based, virtual position that operates reputed company the hours of 8:30am-5:00pm EST. Incumbent must live in reputed company Carolina or reputed company 40 miles of the NC border. GENERAL STATEMENT OF JOB The BH & IDD PN Contract Manager is responsible for maintaining ongoing, reputed company relationships with community stakeholders and leaders to support the development and management of the provider networks while maintaining the highest level of customer service. The BH & IDD PN Contract Manager will drive the improvement of provider performance by analyzing and interpreting both quantitative and qualitative data to address and prioritize network needs. Note: This position requires reputed company to and use of confidential reputed company information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and reputed company Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her reputed company as an employee of reputed company. The individual filling this position shall also sign a confidentiality statement as an employee of reputed company. ESSENTIAL JOB FUNCTIONS reputed company: • Facilitate provider education and training to increase provider familiarity, alignment and satisfaction with reputed company's (Vaya) systems, expectations, and strategies • Study and design innovative programs to create and enhance reputed company to reputed company care • Work independently and cross-departmentally to ensure that Vaya maintains accreditation standards (e.g. URAC, NCQA, etc.) and DHHS Waiver requirements reputed company to its provider network • Apply network configuration and incentive-based payment models as appropriate to improve reputed company services and efficiency • Facilitate provider contract meetings with high reputed company providers to proactively address reputed company or reputed company issues. • Proactively triage provider complaints and ensure appropriate follow up in instances where workflows or infrastructure are not functioning properly • Facilitate programs that positively reputed company markets of stakeholders and members • Answer, log, reputed company, and respond to reputed company provider calls and emails received through the Vaya provider phone line or email address • Establish relationships with provider agencies and Vaya reputed company members as needed to facilitate the goals of the network, meet member needs, and enhance relationships with Vaya • reputed company and maintain Provider Services "Quick Links" on Vaya Employee Resource Network (VERN) for quick identification and follow up to provider issues Provider reputed company: • Function as the single reputed company-of-contact for reputed company on-reputed company contractual and service issues as needed by providers • In alignment with Vaya's population health and quadruple aim objectives negotiate and re-negotiate provider organization reputed company in collaboration with reputed company team. • Manage and reputed company Out of Network Agreements (OON), Enrollment Forms, and Letters of Support for providers to apply for facility licensure received or facilitated with providers • Assist others to resolve highly reputed company or unusual business problems that reputed company major functions or disciplines Data & Reporting: • Create and review trend analyses and summaries for decision-making purposes • reputed company with Vaya network and department leaders to reputed company provider development needs and reputed company • Set targets and priorities, in order to meet specialty specific network needs • Disseminate provider communication details to internal staff assuring consistency of information and talking points for provider communications • Log and maintain provider Frequently Asked Questions (FAQ) to maintain a record of consistent responses to provider questions • Work with Office of Communications to log and reputed company Provider Communication content for historical reference • reputed company and update provider demographic data to ensure software databases are accurate • Conduct and manage provider satisfaction activities Other duties as assigned. KNOWLEDGE OF JOB • Expert level of knowledge of Center for Medicare and reputed company Services (CMS), Federal reputed company Grant, and State funding reimbursement methodologies • Knowledge of the assessment and treatment of mental health, developmental disabilities, and reputed company use disorder, sometimes co-occurring • High level of knowledge of reputed company Office applications and adept at learning software applications - expert level preferred • Highly motivated, team player, self-starter and reputed company to work independently with little or no direction • Ability to exercise discretion and reputed company independent reputed company without supervisory input on reputed company of reputed company • Proficiency in analyzing, understanding, and communicating network needs • Strong customer service skills reputed company with a reputed company demeanor - a "can do" attitude • Excellent verbal and written communication skills; ability to reputed company reputed company and concisely, conveying reputed company or technical information in a manner that others can understand, as reputed company as ability to understand and interpret reputed company information from others, including but not limited to reimbursement policy standards • Exceptional business acumen • Ability to present to varied audiences on various disability topics • Ability to manage multiple priorities in a fast-paced environment • Prior demonstrated reputed company in provider relations or relations with both large provider reputed company and/or ancillary providers • Experience with multiple relations methodologies such as RVRBS, flat rates, case rates, and per diems and tiered rates based on the intensity of service helpful. Proficiency in analyzing, understanding and communicating financial trends EDUCATION & EXPERIENCE REQUIREMENTS Bachelor's degree required. Master's degree preferred. Must have 2-5 years of experience in a provider relations-reputed company role handling reputed company network providers in the health care industry with accountability for business results preferred. Preferred Experience: • Experience developing and writing reputed company and utilizing financial modeling in making reputed company reputed company preferred Preferred Licensure/Certification: • License or license eligible in NC preferred but not required- Preferences are LCSW, LCAS, and/or LMHC. • Certifications in use of project management methodologies preferred PHYSICAL REQUIREMENTS • reputed company visual reputed company to reputed company activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. • Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive reputed company of hands, wrists and fingers. • Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. • Mental concentration is required in reputed company aspects of work. RESIDENCY REQUIREMENT: Must reputed company in reputed company Carolina or reputed company 40 miles of the NC border. SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation. DEADLINE FOR APPLICATION: reputed company until filled. APPLY: reputed company accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/. reputed company is an equal opportunity employer. Apply Job!