Senior Provider Contracting Professional
HumanaAbout the role
Become a part of our caring community and help us put health first
The Senior Provider Contracting Professional initiates, negotiates, and executes physician and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.The Senior Provider Contracting Professional 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. May assist with identifying and recruiting providers based on network composition and needs. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Additionally reviews key performance indicators with assigned providers, performs site visits, creates action plans and documents actionable items.
Use your skills to make an impact
Required Qualifications
- 3 or more years of progressive network management experience including provider contracting and/or provider relations/operations in a healthcare or MSO/IPA company
- Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures, reimbursement rates and key performance indicators to providers.
- Excellent written and verbal communication skills
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency in MS Office applications
- Ability to resolve problems independently
- Must live in the State of Florida
Preferred Qualifications
- Bachelor's Degree
- Experience negotiating provider contracts
- Experienced working with large physician groups in provider relations or operations
- Experience with Risk Contracting
- Experience with Value Based Contracting
Additional Information
This role is considered "remote/work at home", however, you must live/work in the State of Florida to be considered for this opportunity.
Work at Home Information
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
#LI-Remote
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.
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.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers andApply for this role
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