Home
/
Comprehensive
/
Provider Contracting Professional
Provider Contracting Professional-March 2024
Salt Lake City
Mar 19, 2025
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
VIEW COMPANY PROFILE >>
About Provider Contracting Professional

  Become a part of our caring community and help us put health first

  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.

  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.

  Use your skills to make an impact

  Required Qualifications

  Our Department of Defense Contract requires U.S. Citizenship

  Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

  Bachelor's degree or relevant provider contracting experience

  HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.

  2 years of experience in negotiating managed care contracts with physician, hospital, ancillary and/or other provider contracts or provider contracting experience

  Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers

  Proficiency in MS Office applications

  Excellent written and verbal communication skills

  Ability to manage multiple priorities in a fast-paced environment

  Detail oriented

  Must be available to work an 8 hour shift Monday - Friday 8:00 am - 5:00 pm in the Eastern or Central Times Zone schedule - due to the needs of the business you may be required to be flexible with your work hours

  Preferred Qualifications

  Value Based Contracting knowledgeScheduled Weekly Hours

  40

  Pay Range

  The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$63,400 - $87,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

  Description of Benefits

  Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

  About us

  Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

  Equal Opportunity Employer

  It is the policy of  Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

  Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Software Engineer (Systems)
Summary: Meta Platforms, Inc. (Meta), formerly known as Facebook Inc., builds technologies that help people connect, find communities, and grow businesses. When Facebook launched in 2004, it changed
Manager HRIS
Amentum is seeking an HRIS Manager to contribute to the success of the Human Resources Information Systems function, focused in the areas of business process framework, reporting and security. This p
Patient Care Assistant (PCA) - Part Time
Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are
Sales Associate
Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an exciting career path, feel welcome to be your whole self and nurture your wellbe
Reliability Engineer
Reliability Engineer Position Description Job Summary The Reliability Engineer will be responsible for investigating and problem solving plant reliability issues utilizing World Class Manufacturing (
Paralegal, Probate
General Function In alignment with CIRIs mission and values, assists with the processing of estates from inception through settlement, including examination of legal documents, research, and applicat
Enterprise Solution Architect
We Are Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations,
Audit Intern | Multiple Locations Summer 2025
Business Title: Audit Intern | Multiple Locations Summer 2025 Requisition Number: 108914 - 65 Function: Audit Area of Interest: Campus State: NY City: Albany Description: Known for being a great plac
Security Officer
Overview Full Time- Days $2,000 Sign On Bonus Available Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our
Phlebotomist, Replacement Pool
Job Summary: Support the laboratory function of providing diagnostic information for use in patient care by ensuring proper collection and processing of laboratory specimens. Perform or assist with s
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved