Provider Contracting Director jobs in Wisconsin

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 Executive
  • Humana
  • Green, WI FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

    The Provider Contracting Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's degree

    • 5 years of negotiating provider contracts including hospital, ancillary and physician contracts

    • 2 years of value-based contracting experience

    • 2 of project leadership experience

    • Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development

    • Excellent written and verbal communication skills and experience presenting to varied audiences

    • Ability to manage multiple priorities in a fast-paced environment

    • Knowledge of Microsoft Office applications

    • Candidates must currently reside or be relocating to the states of WI, MO, IL, KS, NE, MN, ND, SD, or IA to be considered

    Preferred Qualifications

    • Master's Degree

    • Experience with ACO/Risk 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 and 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.


     

    $93,000 - $128,000 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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Executive Director, CSRO
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Executive DirectorCLIENT ASSOCIATION: Coalition of State Rheumatology Organizations, CSROPOSITION(S) REPORTS TO: EDI Consulting PartnerPOSITION(S) THAT REPORT TO YOU: Administrative/Meeting Manager, C...
  • 7 Days Ago

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Administrative Manager, SRS
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Administrative ManagerCLIENT ASSOCIATION: Scoliosis Research Society, SRSPOSITION(S) REPORTS TO: Executive Director, SRSPOSITION(S) THAT REPORT TO YOU: N/AEXEMPT/NON-EXEMPT EMPLOYEE STATUS: Exempt (Mi...
  • 2 Days Ago

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Communications and Project Manager, SRI
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Communications and Project ManagerCLIENT ASSOCIATION: Society for Reproductive Investigation, SRIPOSITION REPORTS TO: Executive DirectorEXEMPT/NON-EXEMPT EMPLOYEE STATUS: Exempt (Minimum of 37.5 hours...
  • 3 Days Ago

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Membership & Communications Manager, CAHON
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Membership & Communications ManagerCLIENT ASSOCIATION: Chinese American Hematologist Oncologist Network. CAHONPOSITION REPORTS TO: Executive DirectorEXEMPT/NON-EXEMPT EMPLOYEE STATUS: Exempt (Minimum ...
  • 3 Days Ago

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Program Manager, ACDS
  • Executive Director, Inc.
  • Milwaukee, WI FULL_TIME
  • Program ManagerCLIENT ASSOCIATION: American Contact Dermatitis Society, ACDSPOSITION REPORTS TO: Executive DirectorPOSITION(S) THAT REPORT TO YOU: NoneEMPLOYEE CLASSIFICATION: Exempt (Minimum of 37.5 ...
  • 6 Days 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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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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Investigator (Provisional/Classified)
  • New Jersey Courts
  • New Brunswick, NJ
  • When you come to work for New Jersey Judiciary you will join an 8500-member strong TEAM that operates with the highest s...
  • 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

Wisconsin is bordered by the Montreal River; Lake Superior and Michigan to the north; by Lake Michigan to the east; by Illinois to the south; and by Iowa to the southwest and Minnesota to the northwest. A border dispute with Michigan was settled by two cases, both Wisconsin v. Michigan, in 1934 and 1935. The state's boundaries include the Mississippi River and St. Croix River in the west, and the Menominee River in the northeast. With its location between the Great Lakes and the Mississippi River, Wisconsin is home to a wide variety of geographical features. The state is divided into five dist...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$171,228 to $247,300

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