Provider Contracting Network Rep

Care Plus Health Plans provided pay range

This range is provided by Care Plus Health Plans. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$65,000.00/yr - $88,600.00/yr

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.

• Actively communicates contract terms, payment structures, reimbursement rates to providers internal and external constituents.
• Negotiates and maintains contracts with hospital partners to ensure our network meets regulatory and business requirements.
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• 2 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 skills.

• Bachelor's degree.
• Experience with ACO/Risk Contracting.
• Experience with Value Based Contracting.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency in MS Office applications.

• Travel to provider-facing meetings as needed based on business needs.
• Hours - 8am to 5pm EST.

As part of our hiring processůsob we will be using an exciting interviewing technology provided by Hire Vue, 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 pre‑screen, 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 and should anticipate this interview to take approximately 10‑15 minutes. If participating in an SMS Text interview, you will answer a series of questions via your cell phone or computer and is expected to last anywhere from 5‑10 minutes; after which your recorded interview(s) via text and/or pre‑recorded voice will be reviewed and you will be informed if you will move forward to the next round of interviews.

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will receive 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 or job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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 Hum.

STATUS to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and advance 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 or apprenticeship at all levels of employment.

Entry level

Full‑ti…