[Remote] Dental Recontracting Professional - VSP at Humana

San Antonio, Texas, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Part TimeJob Type

UnknownVisa

Health Insurance, DentalIndustries

Requirements

Candidates should have 2-5 years of experience in negotiating managed care contracts with providers or working in a dental office. Proficiency in analyzing and communicating the financial impact of contract terms, payment structures, and reimbursement rates is required. Excellent written and verbal communication skills and the ability to manage multiple priorities in a fast-paced environment are also necessary. Proficiency in MS Office applications and a Bachelor's degree are preferred. Experience with Value Based Contracting and working with dental offices is a plus. Home internet service must meet minimum download and upload speed requirements.

Responsibilities

The Dental Recontracting Professional will initiate, negotiate, and execute provider contracts and agreements, specifically recontracting Humana contracted dentists to new agreements. They will communicate contract terms, payment structures, and reimbursement rates to providers and maintain contracts and documentation within a tracking system. The role may involve identifying and recruiting providers based on network needs. The professional will interpret changes in legislation, develop policies, conduct audits, deliver training, and advise management on risk mitigation strategies.

Skills

Managed care contracting

Negotiation

Provider contracts

Contract analysis

Financial impact analysis

Communication

MS Office

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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