Provider Contracting Professional

Description du poste:

Become a part of our caring community

The Provider Contracting Professional supports the Senior Provider Contracting Professional in the negotiation, analysis, and maintenance of physician and other provider agreements for an organization delivering healthcare to the senior population. This role assists with contract management activities, provides analytical support, and ensures accurate documentation within established processes and guidelines. Assignments involve routine to moderately complex issues where data analysis is required.

Job Responsibilities:
* You will support the contracting team in drafting, reviewing, and processing provider contracts and amendments.
* You will collaborate with market engagement, leadership, and legal teams to facilitate contract execution and resolve basic contract term revisions.
* You will assist in communicating contract terms, payment structures, and reimbursement rates to IPA and ACO provider groups under the guidance of senior staff.
* You will conduct initial financial analyses of contracts and terms; prepare summaries for senior review.
* You will maintain contract files and documentation within the organization's tracking system, ensuring accuracy and compliance.
* You will assist in identifying and reaching out to potential providers for network development based on current needs and network composition.
* You will prepare reports and updates for contracting initiatives as requested.
* You will manage assigned priorities and deadlines, escalating complex issues to senior team members

Required Qualifications
* Minimum of two years' experience in provider contracting, network management, or a related healthcare field.
* Basic knowledge of managed care or value-based contracting.
* Understand contract terms and basic financial impact.

Other Qualifications
* Experience supporting ACO or IPA provider networks.
* Familiarity with contract tracking or management systems.

Use your skills to make an impact

WAH Statement
To ensure Home or Hybrid Home/Office employees', the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
* We recommend at minimum a download speed of 25 Mbps and an upload speed of 10 Mbps; we suggest a wireless, wired cable or DSL connection.
* Leadership approves the use of satellite, cellular and microwave connection.
* We will provide employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota with a bi-weekly payment for their internet expense.
* Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the requirements for their position/job.
* Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Alert
Humana values personal identity protection. Please be aware that we may ask applicants to provide their Social Security Number, if we do not already have it on file. When required, Humana will send an email from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

Interview Format - HireVue
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring. 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.

#LI-JM3

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours
40

Pay RangeThe 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.

$65,000 - $88,600 per year

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

Description of BenefitsHumana, 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

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.
​
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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