[Hiring] Dental Recontracting Professional @Humana

Role Description

The Dental Recontracting Professional initiates, negotiates, and executes dental provider contracts and agreements for an organization that provides dental insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This is a VSP role - work specific hours to meet business needs on a limited term basis. The project is expected to go through mid-2027.

• Recontract Humana contracted dentists to the new agreement.
• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Maintain contracts and documentation within a tracking system.
• Assist with identifying and recruiting providers based on network composition and needs.
• Understand department, segment, and organizational strategy and operating objectives.
• Make decisions regarding own work methods, occasionally in ambiguous situations.
• Follow established guidelines/procedures and work on special projects as needed.

Qualifications

• 2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts and/or working with insurance in a dental office.
• 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.
• Hours worked will be EST/CST.

Requirements

• Experience with Value Based Contracting.
• Experience working with Dental offices.
• Bachelor's degree desired.
• Work at Home Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; wireless, wired cable or DSL connection suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Paid time off.
• 401(k) retirement savings plan.
• Employee assistance program.
• Business travel and accident coverage.