Provider Contract Templates Lead

San Antonio, Texas, United States

Apply with AI Apply

Not SpecifiedCompensation

Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must have a minimum of 5 years of experience in healthcare contracting, including language, build, and negotiations. Demonstrated expertise in drafting and managing contract language, exceptional written communication skills, and strong attention to detail are required. The ability to work collaboratively across departments and with diverse stakeholders, along with a flexible and dynamic personality suited for a team environment, is also necessary. A Bachelor's degree, experience analyzing and interpreting federal and state legal requirements, and familiarity with contract management systems and template automation tools are preferred.

Responsibilities

The Provider Contract Templates Lead is responsible for overseeing the development, maintenance, and optimization of provider contracting templates for Medicare and Medicaid programs. This includes creating and updating templates to ensure compliance with federal, state, and company requirements, and analyzing relevant laws and regulations. The Lead will also manage the review and revision of existing templates, collaborate with internal stakeholders, maintain documentation, and serve as a subject matter expert. Additionally, they will provide training on template use and recommend process improvements.

Skills

Provider contract templates

Medicare

Medicaid

Regulatory compliance

Federal and state contract requirements

Process improvement

Documentation

Version control

Training

Legal analysis

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.

Land your dream remote job 3x faster with AI

Try Jobo Free