Provider Relations Professional - LA

Profile

Description

The Provider Relations Professional initiates and and executes physician and/or other provider contracts and agreements. The Provider Contracting Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. This role is responsible for educating network providers on policies and procedures for Humana plans.

Responsibilities

The Provider Relations 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. 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. The role also provides education to the provider network related to Humana operations and resolution of service issues.

Required Qualifications


1 years knowledge/experience with Louisiana Medicaid
Experience working with healthcare providers educating and and communicating 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
You must live in the State of Louisiana


Preferred Qualifications


Bachelor's Degree
Experience in negotiating managed care contracts with physician, hospital and/or other provider contracts.


Additional Information

This position is considered remote/work at home, however, you must live in the State of Louisiana to be considered for this role, with the ideal candidate living in the Northern part of the State.

Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Company info

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