Provider Contracting Professional

Provider Contracting Professional 2

Become a part of our caring community and help us put health first. Humana Healthy Horizons is seeking a Provider Contracting Professional 2 who initiates, negotiates, and executes physician, hospital, and other provider contracts and agreements related to Medicaid health plans. The Provider Contracting Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Provider Contracting Professional 2 responsibilities include (but not limited to) : 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.

Use your skills to make an impact. Required qualifications include : Must work within the Eastern Standard Time Zone hours, 2+ years of experience in negotiating managed care contracts with physicians, hospitals and / or other provider contracts, 2+ years of network development and Medicaid / Medicare experience, experience with roster data loading, excellent written and verbal communication skills, ability to manage multiple priorities and work independently in a fast-paced environment, moderate to advanced proficiency working with MS Office applications. Preferred qualifications include : Bachelor's degree, experience with New Network Management, experience with QuickBase, proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

Additional information : 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. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job. 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 : $65,000 - $88,600 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance. 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. Application deadline : 11-20-2025.

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 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. 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 accessibility resources at https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.