Senior Provider Contracting Professional - LA Medicaid

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Job Information

Humana

Senior Provider Contracting Professional - LA Medicaid

in

Metairie

Louisiana

Description

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance for Louisiana Medicaid. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Provider Contracting Professional 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. Identifies and recruits providers based on network composition and needs. Makes decisions on moderately complex to complex issues regarding technical approach for project components. Exercises considerable latitude in determining objectives and approaches to assignments. Travels to assigned provider contact offices to provide education and support.

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

o Medical Benefits

o Dental Benefits

o Vision Benefits

o Health Savings Accounts

o Flex Spending Accounts

o Life Insurance

o 401(k)

o PTO including 7 paid holidays, two personal holidays, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

o And more

Required Qualifications

Bachelor's degree

Behavioral health contract negotiation experience

3 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems.

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

Candidate must reside within the state of Louisiana

Preferred Qualifications

Master's Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Experience with Medicaid

Additional Information

This position is remote/work at home, however, you must live in the State of Louisiana to be considered for this role.

Work-At-Home Requirements

WAH 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

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

Company info

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