Senior Provider Contracting Professional

Humana • Work at Home - Illinois, IL

1d • $78,400 - $107,800 • Remote

About The Position

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Contracting Professional 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. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Requirements

• 3+ years of progressive network management experience within a Health Plan
• 3+ years of experience negotiating managed care contracts with large physician groups and ancillary providers in the Illinois market.
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Must live within the State of Illinois

Nice To Haves

• Bachelor's degree or equivalent experience
• Hospital contracting experience
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Responsibilities

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

What This Job Offers

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