Provider Contracting Manager jobs in Missouri

Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Director, Provider Contracting
  • Humana
  • Springfield, MO FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the region of Kansas City and Nebraska. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

    The Director, Provider Contracting 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's Degree

    • 5 years of extensive provider contracting experience inclusive of all provider types

    • Proven leadership experience, including teambuilding

    • Comfortable with hiring and building teams

    • Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies

    • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

    • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

    • Applicant must be located in one of the following states: NE, MO, or KS

    Preferred Qualifications

    • Master's or J.D. Degree
    • Experience with ACO/Risk Contracting
    • Value based contracting experience

    Additional Information

    • Work at Home Requirements

      • Must have the ability to provide a high speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role). 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. 
      • A dedicated space conducive to learning and keeping protected health information (PHI / HIPAA) of our members confidential. Your designated work location must be located away from other household distractions, including but not limited to ensuring that alternate caregiving arrangements are made for dependents or other members in the household.

      • As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.  If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone, and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

      • Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

    Scheduled Weekly Hours

    40

    Pay Range

    The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


     

    $136,200 - $187,400 per year


     

    This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

    Description of Benefits

    Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


    About us
     

    Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


    Equal Opportunity Employer

    It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

  • 11 Days Ago

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Civil Design Manager
  • Castle Contracting
  • St. Louis, MO FULL_TIME
  • Position Summary: Castle Contracting, Inc, is seeking a talented Civil Design Manager to join our growing Civil Design-Build team. This is a unique opportunity for a forward-thinking civil engineering...
  • 5 Days Ago

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Field Supervisor/Project Manager
  • Terrill Contracting
  • St. Louis, MO FULL_TIME
  • Terrill Contracting is looking for an experienced Hardscape/Landscape On-Site Foreman/Project Manager. Starting compensation is $32/hr with the potential for an increase based on skills and experience...
  • 2 Months Ago

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Estimating Manager - Civil and Site Utilities
  • Castle Contracting
  • St. Louis, MO FULL_TIME
  • Position Summary: The Estimating Manager has the primary responsibility of evaluating bid specifications/drawings, to understand the size/scope of the work and complete a comprehensive project estimat...
  • 8 Days Ago

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Pharma Contracting Account Management (Provider Contracting Senior Advisor)- Express Scripts (Hybrid)
  • The Cigna Group
  • St. Louis, MO OTHER,FULL_TIME
  • The job profile for this position is Provider Contracting Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.Excited to grow your career?We value our talented employees, and whenev...
  • 12 Days Ago

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Operations Manager
  • Eureka Contracting and Roofing
  • Eureka, MO FULL_TIME
  • Eureka Contracting and Roofing, located in Eureka, MO, is a reputable and customer-focused contracting company specializing in roofing services. With a commitment to excellence and customer satisfacti...
  • 20 Days Ago

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Provider Contracts Manager
  • Molina Healthcare
  • New York, NY
  • ***Remote and must live in New York*** Job Description Job Summary Molina Health Plan Provider Network Contracting jobs ...
  • 4/14/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Tampa, FL
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Dallas, TX
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Washington, DC
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

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Provider Contract Management Specialist
  • Cambia Health Solutions, Inc
  • Portland, OR
  • Provider Contract Management Specialist Remote opportunity for residents of OR, WA, ID and UT Primary Job Purpose The Pr...
  • 4/12/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Boston, MA
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Los Angeles, CA
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

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Provider Contract Manager *REMOTE Seattle Area*
  • Dexian
  • Austin, TX
  • Position: Provider Contract Manager *REMOTE Seattle Area* Location: Remote - Everett, Seattle, Tacoma, Washington State ...
  • 4/12/2024 12:00:00 AM

Missouri is landlocked and borders eight different states as does its neighbor, Tennessee. No state in the U.S. touches more than eight. Missouri is bounded by Iowa on the north; by Illinois, Kentucky, and Tennessee across the Mississippi River on the east; on the south by Arkansas; and by Oklahoma, Kansas, and Nebraska (the last across the Missouri River) on the west. Whereas the northern and southern boundaries are straight lines, the Missouri Bootheel protrudes southerly into Arkansas. The two largest rivers are the Mississippi (which defines the eastern boundary of the state) and the Misso...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$104,045 to $138,172

Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020