Location
Atlanta, GA, United States
Posted on
Mar 04, 2022
Profile
Job Information
Humana
Provider Contracting Principal
in
Atlanta
Georgia
Description
The Provider Contracting Principal initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Principal works on problems of diverse scope and complexity ranging from moderate to substantial.
Responsibilities
The Provider Contracting Principal 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Bachelor's degree
Experience as a seasoned network leader
Experience with end to end Strategic Provider Relationship Management
8 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
2 or more years of project leadership experience
Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development
Excellent written and verbal communication skills and experience presenting to varied audiences
Ability to manage multiple priorities in a fast-paced environment
Knowledge of Microsoft Office applications
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination, including booster or commit to testing protocols
*OR *
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state and remote-only work exemptions are available.
Preferred Qualifications
Master's Degree
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Additional Information
Scheduled Weekly Hours
40
Company info
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