[Remote] Provider Contracting Coordinator at Humana

Louisiana, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

1 year of provider relations, provider contracting or account management experience
Excellent written and oral communication skills
Ability to manage multiple priorities in a fast-paced environment
Proficiency in Microsoft Excel (manage large volumes of data through tools such as pivot table & V-lookup)
Must live in the State of Louisiana
Ability to work independently with limited guidance
Ability to exercise discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques

Responsibilities

Communicate contract terms, payment structures, and reimbursement rates to providers
Analyze financial impact of contracts and terms
Maintain contracts and documentation within a tracking system
Prioritize requests and interpret and adapt procedures, processes and techniques
Manage multiple priorities in a fast-paced environment
Work independently with limited guidance
Exercise discretion and judgment in decision-making
Regularly communicate with providers and other stakeholders
Ensure accurate and timely completion of administrative tasks and projects
Maintain a dedicated workspace that protects member PHI/ HIPAA information

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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