Manager, Provider Contracting

Humana Inc; Orlando (FL); Remote; USD 94,000 - 131,000; Full time

Job summary

A leading company in health services is seeking a Manager, Provider Contracting to handle physician contracts and lead cross-departmental initiatives. The ideal candidate will have extensive experience in contracting and financial analysis, managing projects in a dynamic environment while ensuring high communication standards. This remote position requires living in Florida and occasional travel for training or meetings.

Benefits

Remote work flexibility

Bonus incentive plan

Qualifications

• 5+ years of progressive contracting experience in a national health plan.
• 2+ years of experience in leading projects or teams.
• Strong knowledge in Risk and Value-based contracting.

Responsibilities

• Negotiate and execute provider contracts and agreements.
• Analyze financial impacts of contracts and terms.
• Collaborate with other departments for effective contract management.

Skills

Negotiation

Financial Analysis

Communication

Project Management

Contract Preparation

Education

Bachelor's Degree

Tools

Microsoft Office

Job description

Job Profile

Manager, Provider Contracting

Job Level

Manager

Become a part of our caring community and help us put health first

The Manager, Provider Contracting initiates, negotiates, and executes physician and/or other provider contracts and agreements. The Manager, Provider Contracting works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

The Manager, Provider Contracting 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. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.

Use your skills to make an impact

Required Qualifications

• 5 or more years of progressive contracting experience for a national health plan
• 2 or more years of experience leading people or projects
• Experience with Risk and Value based contracting
• Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
• Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
• Excellent written and verbal communication skills and experience presenting to varied audiences
• Ability to manage multiple priorities in a fast-paced environment
• Knowledge of Microsoft Office applications
• Must live within the State of Florida
• Ability and willingness to travel as necessary

Preferred Qualifications

• Bachelor's Degree
• Experience with provider engagement and Stars Quality Improvement Programs

Additional Information

This role is "remote/work at home", however, you must live within 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 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.$94,900 - $130,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Referral Bonus Information

This requisition is not eligible for a referral bonus.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.