Provider Contracting Professional (Behavioral Health/Medicaid)
About The Position
The Provider Contracting Professional initiates, negotiates, and executes behavioral health provider contracts for Virginia Medicaid. The Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to Behavioral Health providers. Analyzes the financial impacts of contracts and terms. Maintains contracts and documentation within a tracking system. Identifies and recruits providers based on network composition and needs. Makes decisions on moderately complex issues regarding technical approaches for project components. Engages in contracting negotiations with Behavioral Health physicians and Community Mental Health providers. Exercises considerable latitude in determining objectives and approaches to assignments.
Requirements
- 2+ years of experience in negotiating or servicing managed care contracts with physician, hospital and/or other provider contracts
- Proficiency in analyzing, understanding, and communicating the financial impact(s) of contract terms, payment structures and reimbursement rates to providers
- Excellent written and verbal communication skills
- Proficiency in MS Office applications
- Ability to manage multiple priorities in a fast-paced environment
- Must live within the market to include VA, DC, NC, TN, WV, KY
Nice To Haves
- Bachelor's Degree
- Experience with behavioral health contracts
- Experience working with Medicaid contracts
Responsibilities
- Initiates, negotiates, and executes behavioral health provider contracts for Virginia Medicaid.
- Communicates contract terms, payment structures, and reimbursement rates to Behavioral Health providers.
- Analyzes the financial impacts of contracts and terms.
- Maintains contracts and documentation within a tracking system.
- Identifies and recruits providers based on network composition and needs.
- Makes decisions on moderately complex issues regarding technical approaches for project components.
- Engages in contracting negotiations with Behavioral Health physicians and Community Mental Health providers.
Benefits
- medical
- dental
- vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
