Senior Provider Contracting Professional - Behavioral Health

Humana

4d • $78,400 - $107,800 • Remote

About The Position

The Senior Provider Contracting Professional initiates, negotiates, and executes behavioral health practitioner, hospital, and/or other provider contracts and agreements for Indiana Medicaid and Medicare. 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 Behavioral Health providers in the Indiana Medicaid and Medicare market. Analyzes the financial impact(s) 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. Makes decisions on moderately complex to complex issues regarding technical approach for project components. Exercises considerable latitude in determining objectives and approaches to assignments.

Requirements

• 3+ years of progressive network management experience with key Behavioral Health providers to include Inpatient Psych providers, Inpatient Substance Abuse providers, community mental health centers, and opioid treatment programs
• Experience with negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems
• Proficiency in analyzing, understanding, and communicating the financial impact(s) of contract terms, payment structures, and reimbursement rates to providers
• Provider Relations Experience with Medicare claims
• Excellent written and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Must work in EST or CST time zone.

Nice To Haves

• Master's degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Responsibilities

• Initiates, negotiates, and executes behavioral health practitioner, hospital, and/or other provider contracts and agreements for Indiana Medicaid and Medicare.
• Communicates contract terms, payment structures, and reimbursement rates to Behavioral Health providers in the Indiana Medicaid and Medicare market.
• Analyzes the financial impact(s) 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.

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