Senior Provider Contracting Professional - Behavioral Health/Medicaid

Humana

4d • $78,400 - $107,800 • Remote

About The Position

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers. Provides a comprehensive hospital network to consumers in the behavioral health arena and executes on Humana's consumer-focused business strategy. The Senior Provider Contracting Professional will negotiate with a variety of provider constituencies and provide continual re-prioritization of corporate and consumer needs. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Exercises considerable latitude in determining objectives and approaches to assignments.

Requirements

• 3-4 years of progressive network management experience including hospital contracting and network administration in a healthcare company or healthcare system
• Medicaid behavioral health contracting experience, to include contract negotiation
• Medicaid provider relations experience
• Experienced in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems
• Proficiency in analyzing, understanding, and communicating the financial impact of contract terms, payment structures, and reimbursement rates to providers

Nice To Haves

• Bachelor's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Responsibilities

• Negotiate hospital and ancillary contracts at market competitive pricing
• Initiate and maintain productive long-term relationships with key hospital and group practice administrators and members
• Communicate proactively with other departments in order to ensure effective and efficient business results
• Handle services, levels of care, and pricing on the behavioral health network side
• Subject matter expert on the assigned region/behavioral health network
• Manage large accounts and/or provider relations
• Be comfortable with C-suite interactions, both internally and externally

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior