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Role Description

The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts. The work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

• 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.
• Assists with identifying and recruiting providers based on network composition and needs.
• Makes decisions on moderately complex to complex issues regarding technical approach for project components.
• Exercises considerable latitude in determining objectives and approaches to assignments.

Qualifications

• 3+ years of progressive network management experience.
• Experienced leading negotiations for complex managed care 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 in a fast-paced environment.
• Proficiency in MS Office applications.
• Must live in the State of Florida and be willing and able to travel up to 25% of the time within the region.

Requirements

• Bachelor's Degree (preferred).
• Experience with hospital contracting (preferred).
• Experience with Value Based Contracting (preferred).

Benefits

• 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.
• Many other opportunities supporting whole-person well-being.

Company Description

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.