Provider Contracting Professional (Behavioral Health/Medicaid)

The Provider Contracting Professional initiates, negotiates, and executes behavioral health provider contracts for Virginia Medicaid. This role involves communicating contract terms, payment structures, and reimbursement rates to Behavioral Health providers, analyzing the financial impacts of contracts, maintaining contracts and documentation within a tracking system, identifying and recruiting providers based on network composition and needs, and making decisions on moderately complex issues regarding technical approaches for project components.

About the role

This role is "remote/work at home," however, you must live within reasonable driving distance to the State of Virginia to be considered for this opportunity. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Occasional travel to Humana's offices for training or meetings may be required.

Responsibilities

• Communicate contract terms, payment structures, and reimbursement rates to Behavioral Health providers
• Analyze the financial impacts of contracts and terms
• Maintain contracts and documentation within a tracking system
• Identify and recruit providers based on network composition and needs
• Make decisions on moderately complex issues regarding technical approaches for project components
• Engage in contracting negotiations with Behavioral Health physicians and Community Mental Health providers

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
• Able to manage multiple priorities in a fast-paced environment

Preferred Qualifications

• Bachelor's Degree
• Experience with behavioral health contracts
• Experience working with Medicaid contracts

Additional Information

Scheduled Weekly Hours: 40
Pay Range: $65,000 - $88,600 per year
This role is eligible for a bonus incentive plan.

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

Humana is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.