Provider Contracting Professional

Humana • Orlando, FL

18h • $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 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 2 communicates contract terms, payment structures, and reimbursement rates to providers.

Requirements

• Bachelor's degree
• 2 - 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider 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 reside in Seminole, Orange, Osceola, Brevard.

Nice To Haves

• Master's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Responsibilities

• 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.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Follows established guidelines/procedures.

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