Senior Provider Contracting Professional

HumanaAtlanta, GA
12dRemote

About The Position

Become a part of our caring community and help us put health first The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts. 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. Use your skills to make an impact

Requirements

  • 3 or more years of progressive experience in network management and network administration in a healthcare company
  • Experience 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

Nice To Haves

  • Bachelor's degree
  • Experience negotiating provider contracts
  • Experience with ACO/Risk Contracting
  • Experience with Value Based Contracting
  • Live within the State of Georgia

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
  • Begins to influence department’s strategy

Benefits

  • Humana provides 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 and many other opportunities.
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