Job Details

Senior Provider Contracting Professional - Remote

Location
Albany, NY, United States

Posted on
Dec 03, 2021

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Job Information
Humana
Senior Provider Contracting Professional - Remote
in
Albany
New York
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
One or more years of progressive network management experience including contracting, provider relations and/or network administration in a healthcare company
Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers
Excellent written and verbal communication skills
Ability to manage multiple priorities in a fast-paced environment
Proficiency in MS Office applications
Valid driver's license with reliable transportation and the ability and willingness to travel within the region up to 10% of the time
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
Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems.
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Additional Information
This role is considered work at home and can be based anywhere in the United States.
Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required
Scheduled Weekly Hours
40

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