Provider Contracting Professional 2

Profile

Description

Do you have strong community ties within the LTSS provider community? Do you currently reside in the Southwestern part of Florida? Do you love initiating, negotiating, and executing healthcare provider contracts and agreements for a Fortune 100 organization that provides health insurance? Are you looking to work out of your home with some same day travel? If you answered YES you might be who Humana is looking for in their new Provider Contracting Professional 2 position!! Don't hesitate keep reading and apply now!!

Responsibilities

What we need your help with:

The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to ancillary providers.

Responsible for collecting and maintaining credentialing documents per AHCA standards.

Maintain and develop relationships with internal and external partners (including associations and ancillary providers, such as, Assisted Living Facilities, Skilled Nursing Facilities, Home Health Providers, etc)

Maintains contracts and documentation within multiple internal tracking system including contract tracking and salesforce systems.

Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

COME GROW WITH HUMANA! BENEFITS DAY ONE - STELLAR 401K MATCH - PAID TIME OFF

What you need for success! - Required Qualifications

Bachelor's degree, or equivalent similar position

2 years of experience in negotiating managed care contracts with physician, hospital and/or other ancillary provider contracts.

Prior experience building and maintaining relationships with provider groups

Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

Excellent written and verbal communication skills

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Must live and be able to travel within the following Florida counties: Sarasota, Charlotte, Lee, Collier, Desoto, Glades, Hendry

Work at Home Requirements

Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

What you need to be considered a Superstar! - Preferred Qualifications

Master's Degree

Experience with Florida Medicaid LTSS contracting

Strong, established relationships within the LTSS provider community

Additional Information

Same day travel within areas of Florida 25% or more based on business need of the time

Scheduled Weekly Hours

40

Company info

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