Provider Contracting Professional 2

Humana

4d • $65,000 - $88,600 • Remote

About The Position

The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. 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 2 communicates contract terms, payment structures, and reimbursement rates to our Specialty providers within the Florida region. 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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Requirements

• 2+ years of experience servicing or negotiating managed care contracts with physician, hospital and/or other provider contracts
• Proficiency in analyzing, understanding and communicating 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

Nice To Haves

• Bachelor's Degree
• Experience working with medical claims
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting
• Located in the State of Florida

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements.
• Communicates contract terms, payment structures, and reimbursement rates to Specialty providers within the Florida region.
• 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.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed