Senior Provider Contracting Professional - Behavioral Health

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Job Information

Humana

Senior Provider Contracting Professional - Behavioral Health

in

Jersey City

New Jersey

Description

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts for the Behavioral Health space.

Responsibilities

The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers. Providing a comprehensive hospital network to consumers in the behavioral health arena and executing on Humana's consumer-focused business strategy demands constant negotiation with a variety of provider constituencies and 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. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. In this role you will:

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.

You will handle services and levels of care and pricing on the behavioral health network side

Subject matter expert on their assigned region or states on all things behavioral health networks

Manage large accounts and/or provider relations

C-suite interactions both internally and externally

Required Qualifications

5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

2 years of experience negotiating Behavioral Health contracts with large physician groups, ancillary providers and hospital systems.

Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

Excellent written and verbal communication skills

Ability to manage multiple priorities in a fast-paced environment

Proficiency in MS Office applications

Ability and willingness to travel as required up to 20% of the time

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.

If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.

Preferred Qualifications

Bachelor's Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Additional Information

This position is work at home anywhere in the United States, however, you will cover the Western part of the Country and therefore must be flexible to work in the designated time zone.

Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com