Provider Contracting Professional 2 Jobs

R-305438
Description
The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. 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.
Required Qualifications

• Must live within the State of Florida
• 2+ years of experience in negotiating or servicing managed care contracts
• Proficiency in MS Office applications
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Excellent written and verbal communication skills

Preferred Qualifications

• Experience with ACO/Risk Contracting
• Bachelor's Degree
• Experience with Value Based Contracting

Additional Information
This role is considered "remote/work at home", however, you must live within the State of Florida to be considered for this opportunity.
Work at Home Information
To Ensure Home Or Hybrid Home/Office Associates’ Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Associates Must Meet The Following Criteria

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Satellite, cellular and microwave connection can be used only if approved by leadership
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

Scheduled Weekly Hours
40