The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements.
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. Identifies and recruits providers based on network composition and needs.
- Oneor moreyears of progressive network management experience including contracting, provider relationsand/or network administration in a healthcare company
- 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
- Valid driver's license with reliable transportation and the ability and willingness to travel within the region up to 10% of the time
- We will requirefull COVIDvaccinationfor this jobas weare ahealthcarecompany committed to putting health and safety first for our members, patients, associates and the communities we serve
- If progressed to offer, you will be required to provide proof offullvaccination or documentation for amedical or religious exemptionconsiderationwhereallowed by law.Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work
- Bachelor's Degree
- Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems.
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
This role is considered "hybrid/work at home" which means that when you aren't traveling to provider offices, your time will be split between working in your home office or in Humana's Market Office in Overland Park, KS, once we return to our offices, currently scheduled for January 17, 2022.
Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is requiredScheduled Weekly Hours