Senior Provider Contracting Professional - Remote KS MO AR OK

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Job Information

Humana

Senior Provider Contracting Professional - Remote KS, MO, AR, OK

in

Tulsa

Oklahoma

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. 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. May assist with identifying and recruiting providers based on network composition and needs. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

Bachelor's degree or equivalent work experience

One or more years of progressive network management experience including contracting, provider relations and/or network administration in a healthcare company

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

Candidates must reside in the States of KS, MO, OK or AR to be considered

For this job, associates are required to be fully COVID vaccinated, including booster 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, including booster 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.

Preferred Qualifications

Master's Degree

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

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Scheduled Weekly Hours

40

Company info

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