Provider Contracting Professional 2 - Orlando FL

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Job Information

Humana

Provider Contracting Professional 2 - Orlando, FL

in

Kissimmee

Florida

Description

The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. 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.

Negotiate and re-negotiate high-volume, transactional-style physician and ancillary contracts.

Function as the single point-of-contact for all on-going contractual and service issues as needed by providers.

Facilitate provider education, training them in order to increase their familiarity and satisfaction with Humana's systems and strategies.

Create trend analyses and summaries for decision-making purposes.

Interface with market leaders to align contracting needs and business efforts.

Set targets and priorities in order to meet national and market-specific network needs.

Required Qualifications

2 years of experience working in provider contracting with both large physician groups and ancillary providers and/or provider relations

Proficiency in analyzing, understanding and communicating financial trends

Excellent written and verbal communication skills

Experience presenting to varied audiences

Ability to manage multiple priorities in a fast-paced environment

Knowledge of Microsoft Office applications

Driver's license and vehicle are required

Ability and willingness to travel within the region up to 50% of the time

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.

If you choose to accept an offer for this position, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.

Preferred Qualifications

Bachelor's Degree

Experience with ACO/Risk Contracting

Working knowledge in the areas of Group Practice Management, Long-Term Acute Care, home health, home infusion, behavioral health, ambulatory surgery, and the outpatient experience

Additional Information

This position is considered WAH/Hybrid which means that when you are not traveling to provider offices you will be working from your home office or from Humana's Market office in either Altamonte Springs or Daytona, FL

Travel will be required throughout Orange, Osceola, Volusia, Flagler and Seminole counties - Florida

Humana is an organization with careers that change lives-including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you

Scheduled Weekly Hours

40

Company info

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