Senior Provider Contracting Professional

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )

Humana Senior Provider Contracting Professional in Madison , Wisconsin

Become a part of our caring community and help us put health first

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and / or other provider contracts and agreements for an organization that provides health insurance.

The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Provider Contracting Professional 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.

Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction.

Exercises considerable latitude in determining objectives and approaches to assignments.

Use your skills to make an impact

Required Qualifications

Candidates must live in the states of MN, WI, IL, IA, ND, SD, NE, MO, KS to be considered

Bachelor's degree or equivalent

5+ years of provider contracting including hospital contracting

5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company

Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems

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 in a fast-paced environment

Proficiency in MS Office applications

Preferred Qualifications

Master's Degree

Experience with ACO / Risk Contracting

Experience with Value Based Contracting

Preference to be located in MN

Additional Information

Work Location : Preference is MN (Twin Cities area) with travel up to 25%.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.

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.

To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria :

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

Satellite, cellular and microwave connection can be used only if approved by leadership

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home / Office employees 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

Alert : Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file.

When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana's secure website.

Scheduled Weekly Hours

Pay Range

The 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.

$76,800 - $105,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits

Humana, 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

Humana Inc. (NYSE : HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.

These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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 because he or she is a protected veteran.

It is also the policy of Humanato take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion.

We also provide free language interpreter services. See our https : / / www.humana.com / legal / accessibility-resources?source Humana Website.

J-18808-Ljbffr