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Senior Network Contracting Professional

Company: Humana
Location: Cary
Posted on: March 27, 2020

Job Description:

Description The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Responsibilities The Senior Provider Contracting Professional 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. Begins to influence departments strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Required Qualifications 3+ years of progressive network management experience including provider contracting and network administration in a healthcare company Experienced in negotiating managed care contracts with large physician groups, ancillary providers and/or hospital systems. Proficiency in 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 driver's license with reliable transportation and the ability to travel within the region up to 20% of the time Preferred Qualifications Bachelor's Degree Experience with ACO/Risk Contracting Experience with Value Based Contracting Additional Information Ideal candidate will be based in either the Cary or Charlotte, NC office, but will consider "work at home" within the State of North Carolina, for the right candidate. Scheduled Weekly Hours 40

Keywords: Humana, Cary , Senior Network Contracting Professional, Other , Cary, North Carolina

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