123 applicants

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Company

Original Job Post

Humana · 3 days ago

Provider Contracting Professional

United States

Full-time

Remote

Mid Level

$63K/yr - $87K/yr

2+ years exp

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Insider Connection @Humana

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Responsibilities

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.

Understands Medicaid contracting, including Long-Term Service Support (LTSS) and Home Care Based Services (HCBS) contracting requirements.

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.

Qualification

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Negotiating managed care contractsMedicaid contractsLTSS/HCBS programsFinancial impact analysisMS Office proficiencyInternet speed requirementsHIPAA compliance communication skills manage multiple prioritiesWork independentlyFast-paced environmentACO/Risk ContractingValue Based Contracting

Required

2+ years of experience in negotiating managed care contracts with physicians, hospitals and/or other provider contracts.

Prior successful experience working with Medicaid contracts.

Experience with LTSS/HCBS programs and contracts.

Proficiency in 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 and work independently in a fast-paced environment.

Moderate to advanced proficiency working with MS Office applications.

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Preferred

Bachelor's degree.

Experience with ACO/Risk contracting.

Experience with Value Based contracting.

Benefits

Medical

Dental

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

Company

Humana

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10,001+ employees

http://www.humana.com

H1B Sponsorship

Humana has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Trends of Total Sponsorships

2023 (217)

2022 (257)

2021 (258)

2020 (107)