Dental Recontracting Professional - VSP

Humana

1d•Remote

About The Position

The Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Provider Contracting Professional will recontract Humana contracted dentists to our new agreement and will communicate contract terms, payment structures, and reimbursement rates to providers. Maintain contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed. Follow established guidelines/procedures and work special projects. This role is part of Humana's Variable Staffing Pool (VSP), where associates work specific hours to meet business needs on a limited term basis.

Requirements

2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a dental office.
Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
Excellent written and verbal communication skills.
Ability to manage multiple priorities in a fast-paced environment.
Proficiency in MS Office applications.
Self-provided internet service with a minimum download speed of 25 Mbps and an upload speed of 10 Mbps (wired cable or DSL connection suggested).
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

Experience with Value Based Contracting.
Experience working with Dental offices.
Bachelor's degree.

Responsibilities

Initiate, negotiate, and execute physician, hospital, and/or other provider contracts and agreements.
Recontract Humana contracted dentists to our new agreement.
Communicate contract terms, payment structures, and reimbursement rates to providers.
Maintain contracts and documentation within a tracking system.
Assist with identifying and recruiting providers based on network composition and needs.
Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
Make decisions regarding own work methods, occasionally in ambiguous situations.
Follow established guidelines/procedures and work special projects.