Become a part of our caring community and help us put health first
 

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other Behavioral Health contracts and agreements within the Virginia Medicaid space. 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 providers in building and maintaining Medicaid Behavioral Health provider networks. Analyzes the financial impact(s) of contracts and terms. Maintains contracts and documentation within a tracking system. Will 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 with minimal direction.

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

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Use your skills to make an impact
 

Required Qualifications

• 3-5 years of progressive network management experience including hospital contracting and network administration in a healthcare company

• Experienced in negotiating managed care 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

• Experience with Behavioral Health contracts

• Excellent written and verbal communication skills

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

• Proficiency in MS Office applications

• Must live within reasonable driving distance to the state of Virginia

Preferred Qualifications

• Bachelor's Degree

• Experience with Medicaid contracts

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of  Humana not to 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.