Provider Contracting Professional 2

HumanaWork at Home - Florida, FL
$65,000 - $88,600Remote

About The Position

The Provider Contracting Professional 2 initiates, negotiates, and executes provider and/or hospital-based physician 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 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. 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 in negotiating or servicing managed care contracts
  • 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
  • Must live in either Central or Northeast Florida
  • Willing and able to travel up to 30% within the region with potential overnight stays

Nice To Haves

  • Bachelor's degree
  • Experience with ACO/Risk Contracting
  • Experience with Value Based Contracting

Responsibilities

  • Initiates, negotiates, and executes provider and/or hospital-based physician contracts and agreements.
  • 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.

Benefits

  • medical
  • dental
  • vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance
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