Ohio Provider Contracting Coordinator

Profile

Description

The Provider Contracting Coordinator 3 initiates, negotiates, and executes behavioral health provider contracts and agreements for an organization that provides health insurance.

Responsibilities

The Provider Contracting Coordinator 3 communicates contract terms, payment structures, and reimbursement rates to providers. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically focused on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques.

Provider data auditing for compliance

Data management for reporting

Required Qualifications

1 or more years of provider relations, provider contracting and/or account management experience

Working knowledge of Microsoft Office applications: Excel (pivot tables, v-lookup, large amounts of data)

Excellent written and oral 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

Must reside in the state of Ohio

Preferred Qualifications

Bachelor's Degree

Managed care experience

Value-based contracting experience

Work-At-Home 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

#LI-WG1

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

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