Provider Contracting Director jobs in Texas

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
  • Humana
  • Dallas, TX 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 for an organization that provides health insurance.

    The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

    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.

    Use your skills to make an impact

    Required Qualifications

    Our Department of Defense Contract requires U.S. Citizenship

    Successfully receive interim approval for government security clearance (eQIP Electronic Questionnaire for Investigation Processing)

    Bachelor's degree or relevant provider contracting experience

    HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.

    2 years of experience in negotiating managed care contracts with physician, hospital, ancillary and / or other provider contracts or provider contracting experience

    Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers

    Proficiency in MS Office applications

    Excellent written and verbal communication skills

    Ability to manage multiple priorities in a fast-paced environment

    Detail oriented

    Must be available to work an 8 hour shift Monday Friday 8 : 00 am 5 : 00 pm in the Eastern or Central Times Zone schedule due to the needs of the business you may be required to be flexible with your work hours

    Preferred Qualifications

    Value Based Contracting knowledge

    Scheduled Weekly Hours

    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 decisions 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.

    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.

    Last updated : 2024-02-23

  • 1 Month Ago

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Construction Director
  • MATRIX CONTRACTING SERVICES LL
  • Austin, TX FULL_TIME
  • Description Position Summary: This role sets goals, monitors operations and evaluates results in order to ensure that business objectives and operating requirements are met and in alignment with that ...
  • 24 Days Ago

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Director of Information Systems
  • MATRIX CONTRACTING SERVICES LL
  • Addison, TX FULL_TIME
  • Description Position Summary:This position is responsible and accountable for development and implementation of results focused, innovative solutions for a wide range of activities related to technolo...
  • 16 Days Ago

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Manager, Provider Network Contracting - Dallas/Fort Worth market - Cigna Healthcare -Hybrid
  • The Cigna Group
  • Plano, TX FULL_TIME
  • The job profile for this position is Provider Contracting Advisor, which is a Band 4 Senior Contributor Career Track Role.Excited to grow your career?We value our talented employees, and whenever poss...
  • 1 Month Ago

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Healthcare Provider Sales Director
  • Hispanic Technology Executive Council
  • Houston, TX FULL_TIME
  • Who we are:Accenture is a global professional services company with leading capabilities in digital, cloud and security. Combining unmatched experience and specialized skills across more than 40 indus...
  • 1 Month Ago

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Director of Credentialing & Provider Enrollment
  • NorthStar Anesthesia
  • Irving, TX OTHER
  • Role Overview NorthStar Anesthesia is seeking a Director of Credentialing & Provider Enrollment to join our team. This is a hybrid role based in Irving, TX. A Smarter Career Investment NorthStar is th...
  • Just Posted

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CNA/LPN On-call Provisional
  • College of St Benedict/St Johns University
  • Collegeville, MN
  • Position Summary Saint John's Abbey invites applications for the on-call positions of CNA and LPN in the Abbey Retiremen...
  • 3/29/2024 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...
  • 3/29/2024 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...
  • 3/29/2024 12:00:00 AM

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Secretary I, President's Office *Provisional*
  • Monroe Community College
  • Rochester, NY
  • Job Description: Job Function: This is a senior level secretarial position responsible for performing various confidenti...
  • 3/29/2024 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...
  • 3/28/2024 12:00:00 AM

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Assistant Accountant (Provisional)
  • City of Buffalo, NY
  • Buffalo, NY
  • An incumbent to a position in this class performs professional accounting work of more than ordinary difficulty in maint...
  • 3/28/2024 12:00:00 AM

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Provisionally Licensed Clinician, LAC, LSW
  • Human Institute
  • Totowa, NJ
  • HUMAN INSTITUTE PSYCHOLOGY AND THERAPY Provisionally Licensed Clinician, LAC, LSW $35 to $45/hr Full-time or Part-time C...
  • 3/28/2024 12:00:00 AM

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Payroll Specialist (Provisional) CBO
  • Wayne-Finger Lakes BOCES
  • Newark, NY
  • Regional Support Center - Central Business Office $48,000-$60,000 This is a competitive position. Must meet requirements...
  • 3/27/2024 12:00:00 AM

Texas (/ˈtɛksəs/, locally /ˈtɛksɪz/; Spanish: Texas or Tejas Spanish pronunciation: [ˈtexas] (listen)) is the second largest state in the United States by both area and population. Geographically located in the South Central region of the country, Texas shares borders with the U.S. states of Louisiana to the east, Arkansas to the northeast, Oklahoma to the north, New Mexico to the west, and the Mexican states of Chihuahua, Coahuila, Nuevo León, and Tamaulipas to the southwest, while the Gulf of Mexico is to the southeast. Houston is the most populous city in Texas and the fourth largest in the...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$169,198 to $244,368

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