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

    The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

    The Senior Provider Contracting Professional 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. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's degree

    • 5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

    • Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems

    • 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

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

    • Candidate must reside in KS, NE, MO, IA, IL, SD, ND, WI, or MN

    Preferred Qualifications

    • Master's Degree

    • Experience with ACO/Risk Contracting

    • Experience with Value Based Contracting

    • Preferred candidates will reside in KS, NE, or MO

    Additional Information

    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

    As part of our hiring process for this opportunity, we will be using an 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.

    Work at Home / Internet Guidance:

    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

    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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


     

    $76,800 - $105,800 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.

  • 9 Days Ago

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Senior Provider Contracting Professional
  • Humana
  • Remote, MO FULL_TIME
  • This job offer is not available in your country. Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, Humana ) offers competitive benefits that support whole-person well-...
  • 16 Days Ago

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Provider Contracting Advisor - Evernorth Behavioral Health - Hybrid
  • The Cigna Group
  • St. Louis, MO FULL_TIME
  • Please Note: This role is hybrid with the expectation of working 3 days per week onsite and 2 days per week remote. The Provider Contracting Advisor (PCA) is responsible for the overall management of ...
  • 7 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...
  • 24 Days Ago

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Director of Provider Communication
  • Compass Health Network
  • Raymore, MO FULL_TIME
  • Compensation: The Director of Provider Communications role is to ensure Compass Health Network provider communication, strategic plans, and project operations run smoothly.Essential Functions include:...
  • 4 Days Ago

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PracticeLink | Director of Provider & Data Services
  • PracticeLink/MountainPlex
  • St. Louis, MO FULL_TIME
  • Are you humble, hungry, and smart? At PracticeLink.com, regardless of role or position, these are the personal traits we look for in a potential new colleague and teammate. Our culture is built on col...
  • 1 Month Ago

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Provisional Employee
  • WK Kellogg Co
  • Omaha, NE
  • At WK Kellogg Co, we exist to create joy and connection to inspire Gr-r-reat days. We believe that doing good is always ...
  • 6/11/2024 12:00:00 AM

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Personnel Clerk - Provisional
  • Nassau BOCES
  • Garden City, NY
  • Personnel Clerk - Provisional JobID: 1661 Position Type: Classified Staff/PERSONNEL CLERK Date Posted: 5/30/2024 Locatio...
  • 6/11/2024 12:00:00 AM

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Provisioner/ Logistics Specialist
  • CACI International
  • Aberdeen Proving Ground, MD
  • Provisioner/ Logistics Specialist Job Category: Logistics Time Type: Full time Minimum Clearance Required to Start: Secr...
  • 6/11/2024 12:00:00 AM

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RTE Provisioner SC
  • E.A. Sween
  • Hodges, SC
  • We are always looking for talented, hardworking people to join the E.A. Sween family. We are a third-generation family-o...
  • 6/10/2024 12:00:00 AM

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VoIP Provisioner
  • Edge Communications
  • Plano, TX
  • Job Description Job Description Title: VoIP Provisioner Reports to: Manager – Carrier Services Location: Plano Date: 05/...
  • 6/9/2024 12:00:00 AM

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Provisional Case Manager
  • San Andreas Regional Center
  • Salinas, CA
  • Job Summary: While maintaining good public relations and implementing the goals and vision of the regional center, this ...
  • 6/8/2024 12:00:00 AM

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Typist-Provisional MS
  • Canandaigua City School District
  • Canandaigua, NY
  • TYPIST-PROVISIONAL* Needed at the Middle School Full-time, 12-month position Starting as soon as possible Benefits provi...
  • 6/7/2024 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...
  • 6/7/2024 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
$165,162 to $238,539

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