Provider Contracting Representative

Humana

1d • $65,000 - $88,600 • Remote

About The Position

The Provider Contracting Professional 2 initiates, negotiates, and executes ancillary contracts agreements (LTSS/HCBS) for an organization that provides health insurance. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Requirements

• Two (2) or more years of experience negotiating managed care contracts with physicians, hospitals and/or other healthcare provider contracts.
• One (1) or more years of experience in Long-Term Services and Supports (LTSS).
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Proficiency in MS Office applications.

Nice To Haves

• Bachelor's degree.
• Experience with ACO/Risk Contracting.
• Experience with Value-based Contracting.

Responsibilities

• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Analyze financial impact of contracts and terms.
• 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 objectives, including their linkages to related areas.
• Follow 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
• Education Level: Associate degree