Senior Provider Contracting Professional

Humana • Work at Home - Florida, FL

3d • $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 for a health insurance organization. This role involves moderately complex to complex issues requiring in-depth evaluation of variable factors. The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers, analyzes the financial impact of contracts, and maintains contract documentation within a tracking system. This position may also assist with identifying and recruiting providers based on network composition and needs, and begins to influence department strategy. Decisions are made on moderately complex to complex issues regarding technical approach for project components without direction, and considerable latitude is exercised in determining objectives and approaches to assignments.

Requirements

• 3+ years of progressive network management experience
• Experienced leading negotiations for complex 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 the State of Florida and be willing and able to travel up to 25% of the time within the region

Nice To Haves

• Bachelor's Degree
• Experience with hospital 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.
• Begins to influence department’s strategy.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior