Provider Contracting Director jobs in Missouri

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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Director, Provider Contracting
  • Humana
  • Springfield, MO FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the region of Kansas City and Nebraska. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

    The Director, Provider Contracting 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's Degree

    • 5 years of extensive provider contracting experience inclusive of all provider types

    • Proven leadership experience, including teambuilding

    • Comfortable with hiring and building teams

    • Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies

    • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

    • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

    • Applicant must be located in one of the following states: NE, MO, or KS

    Preferred Qualifications

    • Master's or J.D. Degree
    • Experience with ACO/Risk Contracting
    • Value based contracting experience

    Additional Information

    • Work at Home Requirements

      • Must have the ability to provide a high speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role). Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
      • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. 
      • A dedicated space conducive to learning and keeping protected health information (PHI / HIPAA) of our members confidential. Your designated work location must be located away from other household distractions, including but not limited to ensuring that alternate caregiving arrangements are made for dependents or other members in the household.

      • As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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 HireVue 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.

      • Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

    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.


     

    $136,200 - $187,400 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.

  • 19 Days Ago

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Director-Value Based Contracting Analytics
  • SSM Health
  • Saint Louis, MO FULL_TIME
  • SSM Health — a nationally recognized Catholic, not-for-profit integrated health system serving Illinois, Missouri, Oklahoma, and Wisconsin is seeking a Director - Medical Analytics.To request addition...
  • 20 Days Ago

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Senior Director - Value Based Contracting
  • SSM Health
  • Jefferson City, MO FULL_TIME
  • Provides functional leadership and senior administrative oversight in regard to performance of value based and advanced payment mode relationships, risk-based contracting, strategic initiative operati...
  • 1 Month Ago

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Pharma Contracting Account Management (Provider Contracting Senior Advisor)- Express Scripts (Hybrid)
  • The Cigna Group
  • St. Louis, MO OTHER,FULL_TIME
  • The job profile for this position is Provider Contracting Senior Advisor, which is a Band 4 Senior Contributor Career Track Role.Excited to grow your career?We value our talented employees, and whenev...
  • 20 Days Ago

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Director, Advanced Practice Provider
  • SSM Health
  • Saint Louis, MO FULL_TIME
  • It's more than a career, it's a callingMO-SSM Health Cardinal Glennon Children's HospitalWorker Type:RegularJob Highlights:Named 150 Top Places to Work in Healthcare 2023 - Becker's Healthcare Named O...
  • 10 Days Ago

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Housing Specialist
  • Housing provider
  • Joplin, MO FULL_TIME
  • LOCAL HOUSING provider is seeking a full-time clerical person.Responsibilities include assisting in the review and verification of applications for public housing, along with exercising considerable j...
  • 19 Days Ago

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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 ...
  • 4/24/2024 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...
  • 4/23/2024 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...
  • 4/23/2024 12:00:00 AM

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Thermostat Repairer- Provisional
  • CUNY
  • Bronx, NY
  • Thermostat Repairer- Provisional Job ID 28288 Location Bronx Community College Full/Part Time Full-Time Regular/Temporar...
  • 4/22/2024 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...
  • 4/22/2024 12:00:00 AM

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Judiciary Clerk 3 (Provisional)
  • New Jersey Courts
  • Elizabeth, NJ
  • Salary: $42,827.46 - $64,864.16 Annually Location : Elizabeth, NJ Job Type: Full Time Job Number: 2024-09553 Central Off...
  • 4/22/2024 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 populati...
  • 4/22/2024 12:00:00 AM

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Judiciary Clerk 3 (Provisional)
  • New Jersey Courts
  • Freehold, NJ
  • Salary: See Position Description Location : Freehold, NJ Job Type: Full Time Remote Employment: Flexible/Hybrid Job Numb...
  • 4/21/2024 12:00:00 AM

Missouri is landlocked and borders eight different states as does its neighbor, Tennessee. No state in the U.S. touches more than eight. Missouri is bounded by Iowa on the north; by Illinois, Kentucky, and Tennessee across the Mississippi River on the east; on the south by Arkansas; and by Oklahoma, Kansas, and Nebraska (the last across the Missouri River) on the west. Whereas the northern and southern boundaries are straight lines, the Missouri Bootheel protrudes southerly into Arkansas. The two largest rivers are the Mississippi (which defines the eastern boundary of the state) and the Misso...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$164,408 to $237,448

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