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Job Information

Humana Manager, Behavioral Provider Contracting in Colorado Springs, Colorado

Description

The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and facilities. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Comprehensive knowledge of Managed Care in general and understanding of behavioral health specialized services. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. The role will manage a team of contractors along with training, support and development of those associates.

Responsibilities

The Manager, of Behavioral Health Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers and facilities. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Comprehensive knowledge of Managed Care in general and understanding of behavioral health specialized services. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. The role will manage a team of contractors along with training, support and development of those associates.

Required Qualifications

  • Bachelor's Degree

  • 6 or more years of progressive contracting experience for a national health plan or large health system

  • 2 or more years of management experience including supervising and team building

  • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

  • Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies

  • Excellent written and verbal communication skills and experience presenting to varied audiences

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

  • Strong working knowledge of Microsoft Office applications to include proficiency with MS Excel with the ability to manipulate and analyze data

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Ability to travel up to 25%

Preferred Qualifications

  • Master's Degree and/or Clinical experience (RN, LCSW, LPC)

  • Comprehensive knowledge of behavioral health services, provider types, and specialties

  • Experience with ACO/risk contracting and/or path to value agreements/capitation

  • Experience with medical and or behavioral Medicaid contracting

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Additional Information

This role is a leadership role with oversight of 6 direct reports

Scheduled Weekly Hours

40

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