BH Provider Engagement Specialist III
Core
Lead provider contracting, engagement, and network performance for high-value behavioral health partners in the Massachusetts market.
Role type
Senior provider engagement and contracting specialist
Builds
Provider network performance, new product expansion, and Value Based Reimbursement agreements
Domain
Healthcare / Behavioral Health / Managed Care
Deliverable
client delivery
Required skills
Provider contracting, network management, negotiation, financial data analysis, regulatory compliance, population health strategies, practice transformation support, JOC leadership
Preferred skills
Master's degree, NCQA PCMH experience, Six Sigma or Project Management certification, behavioral health credentials
Technologies
Microsoft Outlook, Word, Excel
Responsibilities
Execute quality and engagement strategy; lead market performance initiatives; recruit and credential providers; negotiate contracts and reimbursement rates; analyze financial data for strategic initiatives; drive quality outcomes via Value Based Reimbursement; lead Joint Operating Committees; provide on-site practice transformation support; resolve complex provider issues; evaluate policy changes; ensure regulatory compliance; mentor new hires
Seniority
Senior, hands-on IC with strategic leadership