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Humana Provider Contracting Professional in Las Vegas, Nevada

Description

The Provider Contracting Professional 2 Behavioral Health Network role; initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements to include Medicare gap closing/contracting

Responsibilities

The Provider Contracting Professional 2 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. 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. Follows established guidelines/procedures.

Required Qualifications

  • Minimum of Associate's degree

  • 2+ years of experience in negotiating managed care contracts with physician, hospital and/or other provider contracts​

  • Medicare gap closing/contracting experience and understanding

  • Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers

  • Proficiency in MS Office applications

  • Excellent written and verbal communication skills

  • Ability to manage multiple priorities in a fast-paced environment

  • Ability to travel 25%

Preferred Qualifications

  • Bachelor's degree or Master's Degree

  • Experience with ACO/Risk Contracting

  • Experience with Value Based Contracting

Additional Information

This role will be remote/work at home, anywhere in the United States

Scheduled Weekly Hours

40

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