Contract Tools, Education, Processes Lead

Description

The Contract Tools, Education, Processes Lead exercises independent judgment and decision making on complex issues related to our Medicaid provider templates, standard documentation, policy and protocol, and disseminates best in class knowledge. The Contract Tools, Education, Processes Lead leads others on development of Medicaid methods and approach for creating, managing and the implementation of Humana’s provider contracting documents.

Responsibilities

The Contract Tools, Education, Processes Lead advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

Responsibilities Include

• Building Medicaid templates

• Creating Medicaid standard documentation, policy and protocol

• Managing case studies

• Disseminating best in class knowledge

• Analyzing reimbursement methodologies and rates compared to Medicaid and business goals providing strategic direction to market management for potential implementation

Required Qualifications

• Bachelor's Degree

• At least 1 year of Medicaid provider contracting experience

• 5+ years of provider contracting experience

• At least 1 year of experience leading projects

• Previous healthcare experience

• Solid experience building templates, standard documentation, policy and protocol, and case studies

• Experience working in a matrix-oriented environment

• Flexible, dynamic personality who works well in a team environment

• Possesses a solid understanding of how organization capabilities interrelate across department(s)

• Clear oral and written communication skills

Preferred Qualifications

• Managed care experience

• Master's Degree or Juris Doctorate

Work-At-Home Requirements

• Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

• Satellite and Wireless Internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$102,200 - $140,700 per year

 

This 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.