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 for an organization that provides health insurance. 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
• Use your skills to make an impact

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree