Provider Contracting Professional 2
Remote US, United States
The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts for Humana's Medicaid line of business. 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. 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. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
- 2+ years of experience in negotiating or servicing managed care contracts
- Experience with Medicaid contracting
- 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
Preferred Qualifications
- Bachelor's degree
- Experience with Value Based Contracting
Additional Information
This role is "remote/work at home" and can be based anywhere in the United States.
Work at Home Information
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) …This job isn't fresh anymore!
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California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Montana Occasional travel Occasional travel required Remote position Remote US South Dakota Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota
Benefits/Perks401(k) 401k retirement 401k Retirement Savings Bonus Incentive Bonus incentive plan Caring community Competitive benefits Dental Disability Healthcare decisions Health first Holidays Life Life Insurance Medical Occasional travel Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Remote position Smart healthcare decisions Support whole-person well-being Time off Vision Vision Benefits Volunteer time Volunteer time off Wellness support Whole-person well-being Work From Home
Tasks- Analyze financial impact
- Communicate contract terms
- Communication
- Documentation
- Interpretation
- Maintain documentation
- Manage multiple priorities
- Negotiate contracts
- Recruit providers
- Training
Analyzing Assist BI Business Communication Compensation Contracting Contract Negotiation Dental Documentation Education Financial analysis Healthcare Healthcare services HIPAA Insurance IT Leadership Life Insurance Managed Care Managed Care Contracts Medicaid Medicare MS Office Negotiating Network Organizational Policy Provider Contracting Recruiting Recruitment Strategy Support Training Travel Verbal communication Vision Wellness
Experience2 years
EducationAssociate Bachelor Bachelor's Bachelor's degree Business Communication Education Healthcare Higher IT MS
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9