Provider Contracting Professional

Humana

1d • $65,000 - $88,600 • Remote

About The Position

The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts. 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 servicing or negotiating managed care contracts
• Proficiency in analyzing, understanding, and communicating the financial impact(s) of contract terms, payment structures and reimbursement rates to providers
• Excellent written and verbal communication skills
• Proficiency in MS Office applications
• Ability to manage multiple priorities in a fast-paced environment

Nice To Haves

• Bachelor's Degree
• Experience with behavioral health contracting
• Experience working with Medicaid contracts

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts.
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree