Senior Provider Contracting Professional

Humana Inc; Orlando (FL); Remote; USD 78,000 - 108,000; Full time

Job summary

Join a leading healthcare company as a Senior Provider Contracting Professional, where you will engage in contract negotiations and manage provider relations. This role emphasizes financial analysis of contracts and involves significant responsibility in maintaining provider networks, ensuring a positive impact on healthcare accessibility. Enjoy a competitive salary and comprehensive benefits while working remotely from Florida.

Benefits

Medical, dental, and vision benefits

401(k) retirement savings plan

Paid time off and parental leave

Short and long-term disability

Life insurance

Qualifications

• 3+ years of network management experience in healthcare or MSO/IPA company.
• Experience in provider contracting and relations.
• Ability to resolve problems independently.

Responsibilities

• Initiates, negotiates, and executes provider contracts.
• Communicates contract terms and analyzes financial impacts.
• Maintains contracts in tracking systems and performs site visits.

Skills

Excellent written and verbal communication skills

Ability to manage multiple priorities in a fast-paced environment

Proficiency in analyzing financial impacts of contract terms

Education

Bachelor's Degree

Tools

MS Office applications

Job description

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 a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

#LI-Remote

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.$78,400 - $107,800 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.