Provider Contracting Network Rep

Provider Contracting Professional 2Become 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. Provider Contracting Professional 2:Actively communicates contract terms, payment structures, reimbursement rates to providers internal and external constituentsNegotiating and maintaining contracts with hospital partners to ensure our network meets regulatory and business requirementsManaging relationships with key providers to support member access, minimize disruption, and maintain competitive advantageEnsuring contract terms are implemented accurately and that our organization is protected from risk, both financially and legallySupporting cross-functional teams with timely updates on contracting status, rate changes, and network developmentsManaging these contract relationships with large statewide hospital systems requires the team to work with internal and external constituents on all areas of contracting; network management; adequacy and gaps; provider education; conflict resolution; claim escalation and research; compliance initiatives and grievances; joint operating committees; and all other facets of the business while also working closely with our Humana counterparts on enterprise initiativesUse your skills to make an impactRequired Qualifications2 or more years of experience in negotiating managed care contracts with physician specialty, hospital and/or other provider contracts.Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.Experience with public speaking and presentation skillsPreferred QualificationsBachelor's degreeExperience with ACO/Risk ContractingExperience with Value Based ContractingExcellent written and verbal communication skillsAbility to manage multiple priorities in a fast-paced environmentProficiency in MS Office applicationsAdditional InformationTravel to Provider facing meetings as needed based on business needsHours- 8am to 5pm ESTAs part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Work at Home GuidanceTo ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates 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 associates 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 informationInternal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter Please be sure to provide the requisition number so we may be able to research your request quicker.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. $65,000 - $88,600 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.Application Deadline: 01-14-2026About UsAbout 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 committed to putting health first for our teammates, our customers, and our 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, 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. 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.