Senior Provider Contractor
成为我们关心社区的一部分高级供应商承包商/高级提供商承包专业人员为医疗保险机构创办，谈判和执行医生，医院或其他提供商合同和协议。你将报告给经理，提供商承约者。作为高级提供商采购商，你将：·向提供商沟通合同条款，支付结构和退还率。·分析合同和条件的财务影响。·在跟踪系统内维护合同和文档。·根据网络组成和需求确定和招聘提供商。需要的资格 · 5 年或以上的先进网络管理经验，包括医生和/或医院合同 · 与大型医疗团体，辅助提供商和/或醫院系统进行管理护理合约谈判的经验 · 对合同条款，支付结构和退还率对供应商的影响分析，理解和沟通的能力 · 在中部或东北部佛罗里达州居住优先资格 · 本科学位 · ACO/风险合同经验 · 基于价值的合同合同经历额外信息 · 愿意和能够在该地区内旅行，可能会有30%的夜间住宿 在家工作要求：为了确保家庭或混合家庭/办公室员工能有效地工作，家庭或混合住宅/办公厅员工自给提供互联网服务必须满足以下标准：至少需要下载速度为25 Mbps,加载速度是10 Mbps;建议无线，有线电缆或 DSL 连接。在某些角色中，Humana 所需的最低推互联网速度可能不足以满足业务需求.Humana 保留权利要求合作伙伴必要时升级他们的互联网服務。工作从专用空间缺少持续的中断保护成员 PHI / HIPAA 信息。旅行：虽然这是一个遥远位置，但偶尔需要前往 Humana 办公室进行培训或会议。计划周间40个付费范围 下面的补偿范围内反映了在发布时全职 （40小时每周）工作的初始基本工资的诚信估计。根据地理位置，薪酬范围可能更高或较低，个人薪水将因示范而变化
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Become a part of our caring community
The Senior Provider Contractor / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. You will report to the Manager, Provider Contracting.As the Senior Provider Contracting Professional you will:
- 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.
- Help with identifying and recruiting providers based on network composition and needs.
Use your skills to make an impact
Required Qualifications
- 5 or more years of progressive network management experience including physician and/ or hospital contracting
- Experience 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
- Live in either Central or Northeast Florida
Preferred Qualifications
- Bachelor's degree
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
Additional Information
· Willing and able to travel up to 30% within the region with potential overnight stays
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$78,400 - $107,800 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
Originally posted on Himalayas