Senior Provider Contracting Professional
Company: Humana Inc.
Posted on: June 13, 2021
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
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.
- Bachelor's Degree
- 3 or more years of progressive network management experience
including provider contracting and network administration in a
- Experienced in negotiating managed care contracts with large
physician groups, ancillary providers and/or 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
- Proficiency in MS Office applications
- Must be passionate about contributing to an organization
focused on continuously improving consumer experiences
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
This position will be "work at home", however, you will be
required to travel to provider offices within the South Carolina
Market up to 50% of the time.
Scheduled Weekly Hours
Keywords: Humana Inc., Athens , Senior Provider Contracting Professional, Other , Anderson, Georgia
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