Location
Troy, MI, United States
Posted on
Apr 01, 2021
Profile
Job Information
Humana
Provider Contracting Professional
in
Troy
Michigan
Description
The Provider Contracting Professional 2 Behavioral Health Network role; initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements to include Medicare gap closing/contracting
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.
Required Qualifications
Minimum of Associate's degree
2 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts
Medicare gap closing/contracting experience and understanding
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
Ability to travel 25%
Preferred Qualifications
Bachelor's degree or Master's Degree
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Additional Information
This role will be remote/work at home, anywhere in the United States
Scheduled Weekly Hours
40
Company info
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