Provider Contracting Professional

Description The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. 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 2-5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts. Experience 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 Preferred Qualifications Bachelor's Degree Experience with ACO/Risk Contracting Experience with Value Based Contracting Additional Information This position is considered "remote/work at home", however, you must live in the South Florida area to be considered for this role. WAH 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 For this job, associates are required to be fully COVID vaccinated 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 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. Scheduled Weekly Hours 40