SENIOR PROVIDER CONTRACTING PROFESSIONAL - AZ, LA, MS MARKETS
Company: CenterWell
Location: Oklahoma City
Posted on: November 7, 2024
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Job Description:
Become a part of our caring community and help us put health
firstThe Senior Provider Contracting Professional assists in
negotiation, and execution of provider contracts and agreements for
an organization that provides health insurance. The Senior Provider
Contracting Professional work assignments involve moderately
complex to complex issues where the analysis of situations or data
requires an in-depth evaluation of variable factors.Job
Functions:Partners closely with AZ, LA, and MS market engagement
and leadership teams to support contract execution and drive
towards growth goalsPartners and engages with legal team business
partners to review and address contract term revisionsAbility to
communicate contract terms, payment structures, and reimbursement
rates to IPA and ACO provider(s) groups.Analyzes financial impact
of contracts and terms.Maintains contracts and documentation within
a tracking system.Manages the relationship between the market payor
partners and the PCO market leadershipAssists with new contracts
and amendments with market payors due to changes in market needs or
potential mergers and acquisitions.Contract load and implementation
with payor partners.May assist with identifying and recruiting
providers based on network composition and needs within the IPA/ACO
markets.Begins to influence department's strategy.Makes decisions
on moderately complex to complex issues regarding technical
approach for project components, and work is performed without
direction.Exercises considerable latitude in determining objectives
and approaches to assignments.Use your skills to make an
impactRequired QualificationsBachelor's degree or five years
equivalent experienceA minimum of five years of progressive network
management experience including hospital contracting and network
administration in a healthcare companyExperience with Value Based
ContractingManaging and implementing care contracts with large
physician groups, ancillary providers and hospital
systems.Proficiency in analyzing, understanding and communicating
financial impact of contract terms, payment structures and
reimbursement rates to providers.Excellent written and verbal
communication skillsAbility to manage multiple priorities in a
fast-paced environmentProficiency in MS Office applicationsMust be
passionate about contributing to an organization focused on
continuously improving consumer experiencesPreferred
QualificationsExperience with MSOAdditional InformationTravel to
AZ, LA, MS Markets; Work at Home StatementTo 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 recommended;
wireless, wired cable or DSL connection is suggestedSatellite,
cellular and microwave connection can be used only if approved by
leadershipEmployees 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 informationScheduled
Weekly Hours40Pay RangeThe 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.$76,800 - $105,800 per
yearThis job is eligible for a bonus incentive plan. This incentive
opportunity is based upon company and/or individual
performance.Description of BenefitsHumana, 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 usAbout CenterWell Senior Primary Care:
CenterWell Senior Primary Care provides proactive, preventive care
to seniors, including wellness visits, physical exams, chronic
condition management, screenings, minor injury treatment and more.
Our unique care model focuses on personalized experiences, taking
time to listen, learn and address the factors that impact patient
well-being. Our integrated care teams, which include physicians,
nurses, behavioral health specialists and more, spend up to 50
percent more time with patients, providing compassionate,
personalized care that brings better health outcomes. We go beyond
physical health by also addressing other factors that can impact a
patient's well-being.About CenterWell, a Humana company: CenterWell
creates experiences that put patients at the center. As the
nation's largest provider of senior-focused primary care, one of
the largest providers of home health services, and fourth largest
pharmacy benefit manager, CenterWell is focused on whole-person
health by addressing the physical, emotional and social wellness of
our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers
stability, industry-leading benefits, and opportunities to grow
yourself and your career. We proudly employ more than 30,000
clinicians who are committed to putting health first - for our
teammates, patients, communities and company. By providing flexible
scheduling options, clinical certifications, leadership development
programs and career coaching, we allow employees to invest in their
personal and professional well-being, all from day one.Equal
Opportunity EmployerIt 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
veteran status. 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.Centerwell, a wholly
owned subsidiary of 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 full accessibility rights information
and language options
https://www.partnersinprimarycare.com/accessibility-resources
Keywords: CenterWell, Midwest City , SENIOR PROVIDER CONTRACTING PROFESSIONAL - AZ, LA, MS MARKETS, Other , Oklahoma City, Oklahoma
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