Provider Contracting Professional - Behavioral Health/Medicaid

Humana; United States; Remote; USD 65,000 - 89,000; Full time

Job summary

Humana, a leading health insurance provider, is seeking a Provider Contracting Professional to negotiate and manage contracts in behavioral health. In this role, you'll communicate contract terms to providers and analyze financial impacts, ensuring network needs are met. With a remote work option and competitive benefits, this position offers a chance to make a meaningful impact in healthcare.

Benefits

Medical Benefits

Dental Benefits

Vision Benefits

Health Savings Accounts

Flex Spending Accounts

Life Insurance

401(k)

23 days of annual PTO

Qualifications

• 2+ years in managed care contracts.
• Proficient in analyzing financial impacts.
• Excellent communication skills.

Responsibilities

• Negotiate behavioral health provider contracts.
• Analyze financial impacts of contract terms.
• Recruit providers based on network needs.

Skills

Communication

Analytical skills

Negotiation

Organization

Multi-tasking

Education

Bachelor's Degree

Tools

MS Office

Job description

Provider Contracting Professional - Behavioral Health/Medicaid

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

The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts.

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

The Provider Contracting Professional 2 initiates, negotiates, and executes behavioral health provider contracts.

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.

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 8 paid holidays, one additional personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

Use your skills to make an impact

Required Qualifications

• 2+ years of experience in servicing or negotiating managed care contracts

• Proficiency in analyzing, understanding, and communicating the financial impact(s) 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

Preferred Qualifications

• Bachelor's Degree

• Experience with behavioral health contracting

• Experience working with Medicaid contracts

Additional Information

This role is "remote/work at home" and can be based anywhere in the United States.

Work-at-Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees 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

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$65,000 - $88,600 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 06-16-2025

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

About the company

Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs

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