Provider Contracting Director jobs in Florida

Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Provider Contracting Professional 2
  • Humana
  • Tampa, FL FULL_TIME
  • Become 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. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

    The Provider Contracting Professional 2 communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

    Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

    • Health benefits effective day 1
    • Paid time off, holidays, volunteer time and jury duty pay
    • Recognition pay
    • 401(k) retirement savings plan with employer match
    • Tuition assistance
    • Scholarships for eligible dependents
    • Parental and caregiver leave
    • Employee charity matching program
    • Network Resource Groups (NRGs)
    • Career development opportunities


    Use your skills to make an impact
     

    Required Qualifications

    • 2 years of experience in negotiating or servicing 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

    Preferred Qualifications

    • Bachelor's degree
    • Experience with ACO/Risk Contracting
    • Experience with Value Based Contracting
    • Located in the State of Florida

    Additional Information

    This role is considered "remote/work at home" with the preferred candidate being located within the State of Florida.

    Work at Home Information

    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 recommended; wireless, wired cable or DSL connection is suggested
    • Satellite, cellular and microwave connection can be used only if approved by leadership
    • Employees 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 information

    #LI-Remote

    #LI-JR1

    Scheduled Weekly Hours

    40

    Pay 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.


     

    $63,400 - $87,400 per year


     

    This 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.


    About us
     

    Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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 because he or she is a protected veteran. 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.

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Manager, Provider Services and Contracting
  • Independent Living Systems
  • Orlando, FL FULL_TIME
  • ABOUT USJoin us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiari...
  • 1 Month Ago

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Healthcare Provider Contracting Specialist (HYBRID)
  • Alivi
  • Tallahassee, FL FULL_TIME
  • Job Summary: The Network Development Representative focuses on building Specialty Benefits Networks across multiple Markets/States considering cost negotiations and adequacy to support expected member...
  • 11 Days Ago

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Oncology Medical Director
  • Provider Solutions & Development
  • Miami, FL OTHER
  • Join Oncology Care Partners as a Medical Director and be on the forefront of a new value-based, cancer care model serving patients throughout Florida. You will be a core member of a team that’s provid...
  • 1 Month Ago

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Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • 1 Month Ago

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Senior Director of Managed Care Contracting
  • Sanitas
  • Doral, FL OTHER
  • Job Details Job Location: Miami Dade - Corporate - Doral, FL Salary Range: Undisclosed DescriptionJob Overview: The Director of Managed Care Contracting is accountable for achieving financial and busi...
  • 21 Days Ago

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Licensed Psychotherapist ( Provisionals Accepted)
  • Clinical Counseling and Consulting Services, PLLC
  • Fayetteville, NC
  • Job Description Job Description Job Summary Provides professional psychotherapy/counseling services to clients, families...
  • 4/19/2024 12:00:00 AM

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Construction plans Examiner - Provisional
  • Palm Beach County, FL
  • Palm Beach, FL
  • Examines construction plans for compliance with Florida Building Code, Florida Statutes and County regulations. Reviews ...
  • 4/19/2024 12:00:00 AM

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Stock Clerk (Provisional)
  • City of Buffalo, NY
  • Buffalo, NY
  • Salary: $41,887.00 - $46,336.00 Annually Location : Buffalo Fire Department- 195 Court Street, NY Job Type: Full-Time Jo...
  • 4/18/2024 12:00:00 AM

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Provisional Licensed Counselor
  • Christian Wellness Center Of NJ LLC
  • Somerset, NJ
  • Job Description Job Description Duties/Responsibilities: • Provide counseling for clients and patients, individually and...
  • 4/18/2024 12:00:00 AM

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Licensed Psychotherapist ( Provisional or Fully Licensed)
  • Clinical Counseling and Consulting
  • Fayetteville, NC
  • Job Description Job Description We are seeking a Licensed Psychotherapist ( Provisional Or Fully Licensed) to join our t...
  • 4/18/2024 12:00:00 AM

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Licensed/Provisionally Licensed Therapist
  • Lutheran Family and Children's Services of Missouri
  • Saint Louis, MO
  • Lutheran Family and Children's Services of Missouri is expanding our Behavioral Health services into Springfield, MO! Be...
  • 4/17/2024 12:00:00 AM

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Logistics Provisioner Army Project
  • Conley & Associates, Inc
  • Harvey, LA
  • Job Description Job Description Job Description: Work in Powerlog creating a database as directed. Screen parts and comp...
  • 4/17/2024 12:00:00 AM

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Provisionally Licensed / Associate Level Therapist
  • Destination Therapy
  • Houston, TX
  • Destination Therapy is an Equal Opportunity Employer.We are committed to a diverse workforce that reflects the populatio...
  • 4/16/2024 12:00:00 AM

Florida (/ˈflɒrɪdə/ (listen); Spanish for "land of flowers") is the southernmost contiguous state in the United States. The state is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Atlantic Ocean, and to the south by the Straits of Florida. Florida is the 22nd-most extensive (65,755 sq mi or 170,300 km2), the 3rd-most populous (21,312,211 inhabitants), and the 8th-most densely populated (384.3/sq mi or 148.4/km2) of the U.S. states. Jacksonville is the most populous municipality in the state and the largest city by area in th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$163,890 to $236,701

Provider Contracting Director in New Suffolk, NY
The partners expect that their efforts toward greater collaboration between mutuelles and private providers will contribute to greater financial risk protection of covered citizens and support access to universal health coverage.
January 02, 2020
Provider Contracting Director in Vincennes, IN
The provider of services can choose how to perform the service.
January 27, 2020
Provider Contracting Director in Wichita Falls, TX
The Credentialing Committee is chaired by our Medical Director and they give the final determination if a provider meets our credentialing criteria.
December 05, 2019