FreshRemote.Work

Senior Provider Contracting Professional

Remote US

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 and agreements for an organization that provides health insurance.

The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers.

Typical responsibilities, but not limited to:

  • Analyze 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


Use your skills to make an impact
 

Required Qualifications

  • 2+ years of network management experience this can include: hospital contracting, network administration in a healthcare company or related area

  • Experience working with managed care contracts with large physician groups, ancillary providers and/or hospital systems.

  • Prior experience in MS office applications (Word, Outlook, Excel, PowerPoint)

  • Meet Work at home policy listed in additional information

  • Position does require travel with the assigned geography (Texas) throughout the year (up to 20% and to be determined by leader)

Preferred Qualifications

  • Bachelor's Degree

  • Experience with ACO/Risk Contracting

  • Experience with Value Based Contracting

  • Experienced in negotiating managed care contracts

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work At Home / Internet 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 recommended; 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

SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$76,800 - $105,800 per year


 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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Job Profile

Regions

North America

Countries

United States

Restrictions

California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Montana Remote US South Dakota Travel required 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 Work from home policy

Benefits/Perks

401k Retirement Savings Bi-weekly internet payment Bonus Incentive Bonus incentive plan Caring community Competitive benefits Dental Disability Health insurance Holidays Life Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Support whole-person well-being Telephone equipment provided Time off Vision Vision Benefits Volunteer time Volunteer time off Work From Home

Tasks
  • Analyze financial impact
  • Assist with provider recruitment
  • Documentation
  • Execute contracts
  • Influence strategy
  • Initiate contracts
  • Maintain documentation
  • Negotiate contracts
  • Training
Skills

ACO contracting BI Business Compensation Contracting Documentation Excel Healthcare Health Insurance HIPAA Hospital contracting Insurance Leadership Managed Care Managed Care Contracts Management Medicaid Medicare MS Office Negotiating Negotiation Network Network administration Network management Organization Outlook Policy PowerPoint Provider Contracting Recruitment Risk Risk contracting Security Strategy Technology Training Travel Value-based contracting Wellness Word

Experience

2 years

Education

Associate Bachelor's Bachelor's degree Business Education Healthcare Higher Management MS

Timezones

America/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