Senior Provider Contracting Professional

Become a part of our caring community and help us put health first
 The Senior Provider Contracting Professional initiates, negotiates, and executes physician 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. 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. Additionally reviews key performance indicators with assigned providers, performs site visits, creates action plans and documents actionable items.

Use your skills to make an impact
 

Required Qualifications

• 3 or more years of progressive network management experience including provider contracting and/or provider relations/operations in a healthcare or MSO/IPA company
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures, reimbursement rates and key performance indicators to providers.
• Excellent written and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency in MS Office applications
• Ability to resolve problems independently
• Must live in the State of Florida

Preferred Qualifications

• Bachelor's Degree
• Experience negotiating provider contracts
• Experienced working with large physician groups in provider relations or operations
• Experience with Risk Contracting
• Experience with Value Based Contracting

Additional Information

This role is considered "remote/work at home", however, you must live/work in the State of Florida to be considered for this opportunity.

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 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 …