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Provider Contractor/Large Practice and Ancillary - Jacksonville,
Category: Banking, Health Care Industry , Insurance
  • Your pay will be discussed at your interview

Job code: lhw-e0-85650332

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  Job posted:   Sat Mar 10, 2018
  Distance to work:   ? miles
  1 Views, 0 Applications  
Provider Contractor/Large Practice and Ancillary - Jacksonville,
*Role:*Provider Contractor - Large Practice and Ancillary
*Assignment:*National Contracting
*Location:*Jacksonville, Melbourne, or Daytona Beach, FL and WAH in Florida, FL**

At CarePlus we are more than just a brand, we are a team of associates that strive to give our members what they need to stay happy and healthy. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At CarePlus, we're seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.

*Assignment Capsule*
Be part of the Provider Contracting world at Humana where you will help build and maintain a competitive network for our members.
As a Large Practice and Ancillary Contracting Executive you will support the provider network by utilizing advanced data and analytical methodologies and tools. Use the data to develop and execute programs for process and productivity improvements. Provide servicing and contracting support to participating PCP, MSO, Ancillary and Specialty Providers/Groups. Support and drive strategic initiatives aligned with the organizations and departmental objectives and business strategies.
* Initiate and maintain productive long-term provider-client relationships with external and internal customers.
* Provide effective operation, analytical and negotiation skills to ensure that all contracts are within required guidelines and financial parameters.
* Work with leaders and departments to assure economic and strategic planning models to all endeavors in order to align business, process and operational principles with area-specific goals including expansion markets as assigned.
* Negotiate and re-negotiate Contracts.
* Function as the point-of-contact for all on-going contractual and service issues as needed by Contracted Providers.
* Facilitate Contracted Provider education, training in order to increase their familiarity and satisfaction with CarePlus Health Plans' systems and strategies.
* Create analyses and summaries for identified network gaps and deficiencies.
* Interface with market leaders to align contracting and business needs efforts.
* Set targets and priorities in order to meet national and market-specific network needs.
* Manage multiple projects and priorities
* Act as a project/initiative lead as assigned by leadership
* Provider relations support

*Role Essentials*

High school diploma or equivalent
Minimum of 3 years of Provider Contracting skills with large physician and ancillary groups, including contract preparation and implementation, financial analysis and rate proposal development.
Proficiency in analyzing, understanding and communicating financial trends.
Intermediate knowledge of MS Word and Excel
Overall knowledge of Medicare standards and regulations
Interpersonal and communications skills
Customer Service skills
Strong organizational skills
Valid State of Florida Driver's license
Successful track record in managing multiple projects and priorities
Ability to travel locally up to 50% of the time between Duval and Brevard Counties, must live near the East Coast of Florida

*Role Desirables*

* Bachelor's Degree (BA/BS)
Working knowledge in the areas of Group Practice Management, Long-Term Acute Care, home health, home infusion, behavioral health, ambulatory surgery, and the outpatient experience
*Reporting Relationships*
This position reports to a Director of Network Operations.

*Additional Information*
Humana is an organization with careers that change lives--including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
* *
*Interview Format*
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence*(please be sure to check your spam or junk folders often to ensure communication isn't missed)*inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Please be advised, the role opportunity displayed here is for CarePlus - a wholly owned subsidiary of Humana Inc.

**Title:** *Provider Contractor/Large Practice and Ancillary - Jacksonville, Melbourne, or Daytona Beach, FL and WAH in Florida, FL*

**Location:** *FL-Jacksonville*

**Other Locations:** *US-FL-Daytona Beach, US-FL-Melbourne, US-FL-Tampa*

**Requisition ID:** *188651*

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.

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