Provider Contracting Professional

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.

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Scheduled Weekly Hours

40

Company info

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