Provider Contracting Professional 2

Humana; United States; Remote; USD 65,000 - 89,000; Full time

Job summary

Humana is seeking a Provider Contracting Professional 2 to join its team. This role involves initiating and negotiating provider contracts and ensuring compliance with operational strategies. The ideal candidate will possess robust negotiation skills, analytical capabilities, and the ability to manage multiple priorities in a dynamic environment. Experience in managed care contracts is required, and this position is based in Florida, offering remote flexibility while requiring occasional travel.

Benefits

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off

Short-term and long-term disability

Life insurance

Competitive benefits package

Qualifications

• 2+ years of experience in negotiating managed care contracts.
• Proficiency in analyzing financial impacts.
• Excellent written and verbal communication skills.

Responsibilities

• Initiates and negotiates provider contracts.
• Resolves daily issues for assigned MSOs.
• Communicates contract terms and payment structures.

Skills

Negotiation

Communication

Analytical Skills

Multi-tasking

Education

Bachelor's Degree

Tools

MS Office

Job description

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

The Provider Contracting Professional 2 initiates, negotiates, and executes Large MSO/Physician Group, and/or other provider contracts and agreements. 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 is also responsible for daily issue resolution for their assigned MSOs and their Affiliate groups with direct contracts. Additional work includes KPI review, site visits, provider education, task submission and system maintenance. This associate will work closely with key stakeholder teams such as Service Fund, STARS, MRA, Marketpoint and Finance.

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

The Provider Contracting Professional 2 initiates, negotiates, and executes Large MSO/Physician Group, and/or other provider contracts and agreements. 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 is also responsible for daily issue resolution for their assigned MSOs and their Affiliate groups with direct contracts. Additional work includes KPI review, site visits, provider education, task submission and system maintenance. This associate will work closely with key stakeholder teams such as Service Fund, STARS, MRA, Marketpoint and Finance.

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. The Provider Contracting Professional 2 is also responsible for daily issue resolution for their assigned MSOs and their Affiliate groups with direct contracts. Additional work includes KPI review, site visits, provider education, task submission and system maintenance. This associate will work closely with key stakeholder teams such as Service Fund, STARS, MRA, Marketpoint and Finance .

Use your skills to make an impact

Required Qualifications

• 2 or more years of experience in negotiating or servicing managed care contracts
• 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
• Must live within the State of Florida
• Reliable transportation with the ability to travel within the region up to 25% of the time

Preferred Qualifications

• Bachelor's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Additional Information

This position is considered "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 associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
• Associates 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 associates 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

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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.$65,000 - $88,600 per yearThis 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 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.

About the company

Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs

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