Location
Federal Way, WA, United States
Posted on
Oct 21, 2021
Profile
Job Information
Humana
Senior Provider Contracting Professional
in
Federal Way
Washington
Description
The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
The Senior Provider Contracting Professional 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. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Required Qualifications
Ability to manage multiple priorities in a fast-paced environment
Ability to adapt, learn and utilize Humana internal systems and applications to support contract negotiations and related activities
3 years of progressive network management experience including hospital contracting and network administration in a healthcare company or related experience
Experienced in negotiating managed care contracts with large physician groups, ancillary providers and/or hospital systems or related experience working 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
Proficiency in MS Office applications
We will require full COVID vaccination (**** for this job as 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 or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.
Preferred Qualifications
Bachelor's Degree
Master's Degree (MHA, MBA, etc.)
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Additional Information
Scheduled Weekly Hours
40
Company info
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