Provider Contracting Professional 2

Profile

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. 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. Will need to float between multiple counties in South Florida.

Required Qualifications

High School diploma

2 - 5 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.

40% travel to physician offices

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 have experience with Value Based Contracting

Preferred Qualifications

Bachelor's degree preferred

Experience with ACO/Risk Contracting

Additional Information

Work At Home requirements

This role is considered Agile and you will work from home as well as travel out in the field

This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state Florida driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

Position will be work from home until September at time you will be required to report to the Sunrise, FL Office.

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com