Provider Contracting Representative

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $65k - $88.6k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Initiate, negotiate, and execute ancillary contract agreements (LTSS/HCBS) • Communicate contract terms, payment structures, and reimbursement rates to providers • Analyze the financial impact of contracts and terms • Maintain contracts and documentation within a tracking system • Assist with identifying and recruiting providers based on network composition and needs • Understand department, segment, and organizational strategy and operating objectives • Follow established guidelines and procedures

🎯 Requirements

• Two (2) or more years of experience negotiating managed care contracts with physicians, hospitals and/or other healthcare provider contracts • One (1) or more years of experience in Long-Term Services and Supports (LTSS) • Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers • Proficiency in MS Office applications • Experience with ACO/Risk Contracting (preferred) • Experience with Value-based Contracting (preferred) • Bachelor’s degree (preferred)

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Whole-person well-being and personal wellness support