Company name
Humana Inc.
Location
Lima, OH, United States
Employment Type
Full-Time
Industry
Healthcare
Posted on
Jul 18, 2022
Profile
Description
The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts under the Ohio Medicaid program.
The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. Identifies and recruits providers based on network composition and needs. Makes decisions on moderately complex issues regarding technical approach for project components. Engages in contracting negotiations with Behavioral Health physicians and Community Mental Health providers. Exercises considerable latitude in determining objectives and approaches to assignments.
Responsibilities
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
Medical Benefits
Dental Benefits
Vision Benefits
Health Savings Accounts
Flex Spending Accounts
Life Insurance
401(k)
PTO including 7 paid holidays, two personal holidays, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
Required Qualifications
Bachelor's Degree
2 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts.
Experience with behavioral health contracting
Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
Excellent written and verbal communication skills
Proficiency in MS Office applications
Ability to manage multiple priorities in a fast-paced environment
Must reside in the state of Ohio
Preferred Qualifications
Master's Degree
Experience with Value Based Contracting
Experience working with Medicaid contracts
Additional Information
This position is remote/work at home, however, you must live within the State of Ohio to be considered for this role.
Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
#LI-WG1
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com