Provider Contracting Professional – Behavioral Health, Medicaid

This is a fully remote position, open to applicants in North Carolina, +1 more state.

📋 Description

• Initiate, negotiate, and execute contracts with behavioral health providers for South Carolina Medicaid.

• Clearly communicate the terms of contracts, payment structures, and reimbursement rates to Behavioral Health providers.

• Analyze the financial implications associated with contracts and their terms.

• Maintain all contracts and related documentation within a tracking system.

• Identify and recruit providers based on the composition and needs of the network.

• Make informed decisions on moderately complex issues regarding technical approaches for project components.

• Engage in contract negotiations with Behavioral Health physicians and Community Mental Health providers.

• Determine objectives and strategies for assignments with significant flexibility.

⛳️ Requirements

• A minimum of 2 years of experience in negotiating or servicing managed care contracts with physicians, hospitals, and/or other providers.

• Proficient in analyzing, understanding, and conveying the financial impacts of contract terms, payment structures, and reimbursement rates to providers.

• Must reside within the market, specifically in South Carolina, North Carolina, or Georgia.

• Preferred experience with behavioral health contracts.

• Preferred experience working with Medicaid contracts.

• A Bachelor's Degree is preferred.

• Required minimum internet speed of 25 Mbps download and 10 Mbps upload for remote work.

• Must work from a dedicated space free from continuous interruptions to safeguard member PHI/HIPAA information.

• Occasional travel to Humana offices for training or meetings may be necessary.

🏝️ Benefits

• Bonus incentive plan.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Work-from-home arrangement.