Senior Provider Contracting Professional - TRICARE Behavioral Health

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Job Information
Humana
Senior Provider Contracting Professional - TRICARE Behavioral Health
in
San Antonio
Texas
Description
Responsibilities
The position will provide corporate support to the Director of Provider Contracting and is responsible for assuring that market area network plans are executed and desired government network goals are achieved (i.e. access standards, discount guarantees). The position is responsible for building, maintaining, and analyzing/optimizing a network of over 500,000 providers.
This position is also responsible for IT Compliance EOR review, Network Accreditation compliance/submission/on-site audits, Behavioral Health Network Development and coordination with Humana Provider Administration on contracting efforts or special projects and Humana Network leaders on various contracting and re-contracting opportunities
Additionally this position is responsible for coordination with the field associates, Management of budgets, training, WAH coordination, process improvement, personnel development, change order impact review, and general leadership responsibilities.
KEY ACCOUNTABILITIES
Develop and monitor goals and objectives for network development through Network Implementation plan development
Determine strengths and weaknesses of the network, system, incorporate corrective action plan into business plans
Act as Point of contact for Field Operations, Corporate Provider Administration and Networks
Monitor and report to Director of Provider Contracting on progress and success
Required Qualifications
Our Department of Defense Contract requires U.S. citizenship for this position
Successfully receive approval for government security clearance (eQIP Electronic Questionnaire for Investigation Processing)
Bachelor's degree or equivalent experience
4 years of provider contracts/relations experience, and/or sales/negotiation experience
1 year health plan (field) experience
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to: Provide proof of full vaccination, including booster or commit to testing protocols
*OR  *
Provide proof of applicable exemption including any required supporting documentation. ​​Medical, religious, state and remote-only work exemptions are available.
Preferred Qualifications
Experience with Value Based Contracting
Experience with TRICARE contracts
Graduate degree in Health Care Administration or Business
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

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