Provider Contracting Professional 2 - Miramar FL

Profile

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

Required Qualifications

Associate's degree

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

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

Proficiency in MS Office applications

Excellent written and verbal communication skills

Ability to manage multiple priorities in a fast-paced environment

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

Up to 30% travel in the south Florida area

Preferred Qualifications

Bachelor's degree or Master's Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Additional Information

Under the current circumstances, this role will be work at home, however, as we return to our offices, you will be working out of the Miramar, FL office, when not traveling to provider offices.

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

Scheduled Weekly Hours

40

Company info

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