Provider Contracting Professional – Behavioral Health/Medicaid

🕒 August 18

🌲 North Carolina, South Carolina – Remote

🌲 North Carolina – Remote 🌴 South Carolina – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Initiate, negotiate, and execute behavioral health provider contracts for South Carolina Medicaid • Communicate contract terms, payment structures, and reimbursement rates to Behavioral Health providers • Analyze the financial impacts of contracts and terms • Maintain contracts and documentation within a tracking system • Identify and recruit providers based on network composition and needs • Make decisions on moderately complex issues regarding technical approaches for project components • Engage in contracting negotiations with Behavioral Health physicians and Community Mental Health providers • Determine objectives and approaches to assignments with considerable latitude

🎯 Requirements

• 2+ years of experience in negotiating or servicing managed care contracts with physician, hospital and/or other provider contracts • Proficiency in analyzing, understanding, and communicating the financial impact(s) of contract terms, payment structures and reimbursement rates to providers • Must live within the market to include SC, NC, GA • Preferred: Bachelor's Degree • Preferred: Experience with behavioral health contracts • Preferred: Experience working with Medicaid contracts • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Home-based work arrangement • Dedicated home workspace support for protecting PHI/HIPAA information • Occasional travel to Humana offices for training or meetings