Humana

About Humana

 

Job Category:

Market Strategy - Contracting

Country:

United States

Postal Code:

32801

Approximate Salary:

Not Specified

Position Type:

Full time

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Provider Contracting Professional 2 - Orlando

Humana - Orlando, Florida

Posted: 08/5/2018

Description

The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

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

•    Must have high school diploma or equivalent
•    2 + years of experience in provider relations 
•    Knowledge of analyzing, understanding and communicating 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 
•    Valid State of Florida Driver’s license
•    Ability to travel up to 50% locally in the central Florida areas

Preferred Qualifications

•    Bilingual (English and Spanish), preferred; able to read, write and speak 
•    Experience negotiating managed care contracts with physician, hospital and/or other provider contracts.
•    Bachelor’s Degree (BA/BS)
•    Experience with ACO/Risk Contracting 
•    Experience with Value Based Contracting

Additional Information

Interview Format 
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. 
 
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

 

Scheduled Weekly Hours

40

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