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The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers within the Behavioral Health/Medicaid space. 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.
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
Required Qualifications
2 years of experience in negotiating or servicing managed care contracts with physician, hospital and/or other provider contracts
Experience with provider relations
Proficiency in analyzing, understanding, and communicating the financial impact(s) 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
Preferred Qualifications
Bachelor's Degree
Residency in the state of Oklahoma
Experience with Value Based Contracting
Experience working with Behavioral Health Medicare and Medicaid contracts
Additional Information
This role is considered "remote/work at home", however, the preferred candidates will live/work in the State of Oklahoma.
Work-At-Home Requirements
Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (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
#LI-Remote
#LI-JR1
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$63,400 - $87,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Full Time
Insurance
$97k-125k (estimate)
05/02/2024
08/05/2024
humana.com
TEMPE, AZ
15,000 - 50,000
1961
ALISON RITCHHART
>$50B
Insurance
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 puttin ...
g the customer first.
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The following is the career advancement route for Provider Contracting Professional 2 positions, which can be used as a reference in future career path planning. As a Provider Contracting Professional 2, it can be promoted into senior positions as a Provider Contracting Director that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Provider Contracting Professional 2. You can explore the career advancement for a Provider Contracting Professional 2 below and select your interested title to get hiring information.