96 applicants

Company

Humana · 9 hours ago

Provider Contracting Professional

Remote Nationwide

Full-time

Remote

Entry, Mid Level

$63K/yr - $87K/yr

2+ years exp

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Health CareHealth Insurance

H1B Sponsor Likely

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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, to include 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 contracts experienceFinancial impact analysisLTSS/HCBS programs experienceMS Office proficiencyManaging multiple prioritiesACO/Risk contracting experienceValue Based contracting experience

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.

Preferred

Bachelor's degree.

Experience with ACO/Risk contracting.

Experience with Value Based contracting.

Benefits

401(k)

Medical

Dental

Vision

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

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Trends of Total Sponsorships

2023 (217)

2022 (257)

2021 (258)

2020 (107)