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.
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
o Medical Benefits
o Dental Benefits
o Vision Benefits
o Health Savings Accounts
o Flex Spending Accounts
o Life Insurance
o PTO including 7 paid holidays, two personal holidays, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
o And more
2+ years of experience in negotiating managed care contracts with physician, hospital and/or other provider 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
Valid Driver’s license with reliable transportation with the ability to travel within the region up to 20% of the time
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
This role is considered “remote/work at home” with up to 20% travel to providers offices and occasional visits to Humana’s Miramar office
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office.
A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing or wear a face covering while at work.
We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
Scheduled Weekly Hours