1+ months

Provider Contracting Professional

Humana
Louisville, KY 40290
Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Responsibilities The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. You will develop and grow positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. 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. Required Qualifications + Bachelor's degree + 2 - 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. + Experience in provider engagement and education + 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 be passionate about contributing to an organization focused on continuously improving consumer experiences + Must reside in the state of Kentucky and able to travel to provider offices within an assigned region 50-75% of the time Preferred Qualifications + Master's Degree + Experience with Value Based Contracting + Experience working with Medicaid contracts + Experience with Behavioral Health Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2019-10-28 Expires: 2019-12-27

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Provider Contracting Professional

Humana
Louisville, KY 40290

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