[Hiring] Provider Contracting Representative @Humana

Role Description

The Provider Contracting Professional 2 initiates, negotiates, and executes ancillary contracts agreements (LTSS/HCBS) for an organization that provides health insurance. Your work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• May assist with identifying and recruiting providers based on network composition and needs.
• Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Follow established guidelines/procedures.

Qualifications

• Two (2) or more years of experience negotiating managed care contracts with physicians, hospitals and/or other healthcare provider contracts.
• One (1) or more years of experience in Long-Term Services and Supports (LTSS).
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Proficiency in MS Office applications.

Requirements

• Bachelor's degree (preferred).
• Experience with ACO/Risk Contracting (preferred).
• Experience with Value-based Contracting (preferred).

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities supporting whole-person well-being.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.