Provider Contracting Professional 2

About the Role

Join our dedicated team as a Provider Contracting Professional 2, responsible for initiating, negotiating, and finalizing contracts and agreements with physicians, hospitals, and other healthcare providers. This role involves analyzing the financial implications of contract terms and maintaining comprehensive contract documentation. You will communicate contract details, payment structures, and reimbursement rates to specialty providers within the Florida region. The position requires independent decision-making in varied and sometimes ambiguous situations, adhering to established guidelines and procedures. You will also contribute to identifying and recruiting providers to meet network composition and strategic needs, aligning your work with departmental, segment, and organizational objectives.

Responsibilities

• Initiate, negotiate, and execute contracts with physicians, hospitals, and other healthcare providers.
• Analyze the financial impact of contract terms and payment structures.
• Communicate contract details, payment structures, and reimbursement rates to specialty providers in Florida.
• Maintain and manage contracts and related documentation within a tracking system.
• Identify and recruit providers to align with network composition and strategic requirements.
• Make independent decisions regarding work methods with minimal direction.
• Follow established departmental guidelines and procedures.

Required Qualifications

• A minimum of 2 years of experience in servicing or negotiating managed care contracts with physician, hospital, or other provider agreements.
• Demonstrated proficiency in analyzing, understanding, and clearly communicating contract terms, payment structures, and reimbursement rates to providers.
• Exceptional written and verbal communication abilities.
• Proven ability to manage multiple priorities effectively in a fast-paced work environment.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

Preferred Qualifications

• Bachelor's degree.
• Previous experience working with medical claims processing.
• Experience with Accountable Care Organization (ACO) or risk-based contracting.
• Familiarity with value-based contracting models.
• Residency within the State of Florida is preferred.

Additional Information

This role is designated as remote, with a preference for candidates residing in Florida. For remote or hybrid associates, a stable internet connection with at least 25 Mbps download and 10 Mbps upload speeds is required; wired cable or DSL is recommended. Satellite, cellular, or microwave connections may be used with leadership approval. Associates in California, Illinois, Montana, or South Dakota will receive a bi-weekly internet expense reimbursement. Humana will provide necessary telephone equipment. A dedicated, interruption-free workspace is essential to protect member Protected Health Information (PHI) and ensure HIPAA compliance. Occasional travel for training or meetings may be necessary.

Work Schedule

The standard workweek for this position is 40 hours.

Compensation and Benefits

The annual salary range for this position is $65,000 to $88,600, subject to adjustments based on geographic location and individual qualifications. This role is eligible for a bonus incentive plan tied to company and individual performance. Humana offers a comprehensive benefits package supporting overall well-being, including medical, dental, and vision insurance, a 401(k) retirement savings plan, paid time off, holidays, volunteer time off, parental and caregiver leave, short-term and long-term disability, and life insurance.

Equal Opportunity Employer

Humana is committed to equal employment opportunities and affirmative action. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. All employment decisions are based on job requirements.