Senior Provider Contractor

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 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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.   $78,400 - $107,800 per year   This 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 c