Provider Contracting Professional 1

Position Overview

Become a part of our caring community and help us put health first. The Provider Contracting Professional 1 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. This role's work assignments are often straightforward and of moderate complexity.

Responsibilities

• Communicates contract terms, payment structures, and reimbursement rates to providers.
• Analyzes the 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 own work area professional concepts/standards, regulations, strategies, and operating standards.
• Makes decisions regarding own work approach/priorities, and follows direction. Work is managed and often guided by precedent and/or documented procedures/regulations/professional standards with some interpretation.

Requirements

• Required Qualifications:
  • 2 - 5 years of work experience including educating and negotiating terms of contracts.
  • Proven sales skills with a drive to exceed targets consistently.
  • Detail-oriented and highly organized.
  • Proficiency in analyzing, understanding, and communicating the 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 be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Preferred Qualifications:
  • Experience with Value Based Contracting.
  • Experience working with Dental offices.
  • Bachelor's Degree.
  • Experience with ACO/Risk Contracting.

Employment Details

• Employment Type: Part time
• Location Type: (Not specified)
• Salary: $53,700 - $72,600 per year (This is a full-time equivalent range; actual pay will be prorated for part-time hours.)
• Hours Worked: EST/CST
• Work Arrangement: This role is part of the Variable Staffing Pool (VSP). VSP associates work specific hours to meet business needs on a limited-term basis. The project is expected to go through the end of 2026 with the possibility of extension into 2027.
• Benefits: Eligible for limited benefits, including paid time off and 401(k) retirement savings plan.

Work At Home / Internet Information

• Internet Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps. Wireless, wired cable, or DSL connection is suggested. Satellite, cellular, and microwave connections may be used only if approved by leadership.
• Internet Reimbursement: Employees living and working from home in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Equipment: Humana will provide telephone equipment appropriate for the business requirements of the position.
• Work Environment: Must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel

• While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Company Information

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being.