Provider Contracting Manager jobs in Nevada

Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Provider Contracting Professional
  • Humana
  • UNKNOWN, NV 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 and ancillary, 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.

    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.


    Use your skills to make an impact

    Required Qualifications

    • 3 or more years of experience working with managed care contracts with physician and ancillary, 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 Word, PowerPoint, and Excel applications

    • Valid driver's license and reliable transportation with the ability to travel to provider offices within the region, as well as occasional travel outside the region (This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.)

    Preferred Qualifications

    • Bachelor's Degree

    • Experience with ACO/Risk Contracting

    • Experience with Value Based Contracting

    Additional Information

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

    WAH Internet Statement

    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

    Driving Statement

    This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

    Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on 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 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. 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.


    Not Specified
    0
  • 1 Month Ago

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Delivery Operations Manager
  • Confidential 3PL Provider
  • Sparks, NV FULL_TIME
  • Confidential 3PL provider looking to add an experienced Final Mile Delivery Operations Manager to manage one of our furniture and appliance home delivery operations in the Reno, NV area.This Leader wi...
  • 1 Month Ago

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Construction Project Manager
  • WLH Contracting
  • Paradise, NV FULL_TIME
  • Job Summary:WLH Contracting Limited, a reputable construction company specializing in Commercial construction, is seeking an experienced and motivated Project Manager to join our team. As a Project Ma...
  • 8 Days Ago

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Project Manager
  • Terra Contracting, LLC
  • North Las Vegas, NV FULL_TIME
  • Responsibilities:- Plan, execute, and manage projects from start to finish- Define project scope, goals, and deliverables- Develop detailed project plans and schedules using project management tools s...
  • 14 Days Ago

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Talent Development Manager
  • Terra Contracting, LLC
  • North Las Vegas, NV FULL_TIME
  • Shape the Future of Our Workforce!!We are seeking a dynamic Talent Development Manager to join our team and spearhead initiatives that will shape the future of our workforce. This role is pivotal in e...
  • 19 Days Ago

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Project Manager (GC)
  • Mortgage Contracting Services
  • Las Vegas, NV FULL_TIME
  • Summary: Our mission is to make communities SHINE! Our team provides excellent service to our clients, all while nurturing communities, acting with integrity, and hustling to get the job done. The Pro...
  • 1 Month Ago

Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin. Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$109,613 to $145,566

Provider Contracting Manager in Gastonia, NC
By simplifying and automating the provider contracting lifecycle, we help make it easier for health plans to identify and implement savings opportunities to obtain maximum value from provider relationships.
January 09, 2020
Provider Contracting Manager in Springfield, IL
Responsible for the oversight of their assigned networks to ensure network provider deficiencies are being met and working closely with their assigned Network Support staff and Medical Management counterparts to ensure network needs/changes are being effectively addressed and communicated both internally and externally.
January 19, 2020
Provider Contracting Manager in Cedar Rapids, IA
New care delivery models, complex regulations and narrowing provider networks have significantly altered the provider contract management process.
February 03, 2020