Humana Healthcare Jobs – Contracting Professional

Job 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.

Job 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.

Job Requirements:

• 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
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Ability to manage multiple priorities in a fast-paced environment

Qualification & Experience:

• Experience with ACO/Risk Contracting
• 2 – 5 years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts in lieu Bachelors’ Degree
• Bachelor’s Degree
• Experience with Value Based Contracting
• Masters Degree

Job Details:

Company: Humana

Vacancy Type: Full Time

Job Location: Orlando, FL, US

Application Deadline: N/A

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