Provider Contracting Professional; Dental Network

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The Provider Contracting Professional (Dental Network) initiates, negotiates, and executes dental provider contracts and agreements for the organization. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Provider Contracting Professional (Dental Network) communicates contract terms, payment structures, and reimbursement rates to providers. Analyze financial impact of contracts and terms. Maintain contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed.

Follow established guidelines/procedures. Prioritization of leads, fee schedule reimbursement, needed travel for in person dental office visits, research of local community events and how Humana can support these events, identification of local dental society sponsorship opportunities and assisting providers with a variety of issues. Examples include identifying which fee schedule to offer and also negotiating to determine the value of the provider to all Humana customers based on the compensation.

Meet with Dental Providers face-to-face.

• 2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts.
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Excellent written and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency in MS Office applications
• This role is part of Humana's Driver safety program and therefore requires you to have a valid state driver's license and proof of personal vehicle liability insurance
• Travel is required up to a minimum 20%

• Bachelor's degree
• Master's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

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.

40

$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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Humana:
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our Center Well 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,…