Provider Contracting Manager jobs in Missouri

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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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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Quality Manager
  • Sparks Maintenance Contracting
  • Bowling Green, MO FULL_TIME
  • Legion Industrial Equipment specializes in designing and manufacturing custom industrial solutions. Our commitment to quality and innovation has positioned us as a leader in the industry. We pride our...
  • 2 Days Ago

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Operations Manager
  • Eureka Contracting and Roofing
  • Eureka, MO FULL_TIME
  • Eureka Contracting and Roofing, located in Eureka, MO, is a reputable and customer-focused contracting company specializing in roofing services. With a commitment to excellence and customer satisfacti...
  • 10 Days Ago

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Division Manager
  • DeAngelo Contracting Services
  • Kansas, MO FULL_TIME
  • Company DescriptionDCS is a family owned and operated business with treating all employees like family at the core of our values. Our employees provide innovative, safe and high-quality infrastructure...
  • 16 Days Ago

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Associate Manager - Contract Management
  • Novo Nordisk
  • Plainsboro, NJ
  • About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse an...
  • 6/11/2024 12:00:00 AM

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Contracts Manager
  • Inari Medical, Inc.
  • Irvine, CA
  • Description The Contracts Manager, working independently, closely collaborates with the finance, legal, compliance, and ...
  • 6/11/2024 12:00:00 AM

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Manager - Contract Management and Payer Variance
  • ChristianaCare
  • Wilmington, DE
  • Are you looking for a career opportunity with growth potential at a healthcare organization that is based on excellence ...
  • 6/11/2024 12:00:00 AM

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Provider Contract Management Specialist
  • Naphcare, Inc.
  • Birmingham, AL
  • Overview: NaphCare has an excellent opportunity for a Provider Contracting Specialist to join our Regional Office in Pho...
  • 6/10/2024 12:00:00 AM

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Manager Contract Management
  • McDermott
  • Houston, TX
  • Job Description Company Overview: People power our future. That is why advancing a dynamic, inclusive environment, where...
  • 6/10/2024 12:00:00 AM

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Associate Provider Contract Manager
  • Kaiser Permanente
  • Burbank, CA
  • Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
  • 6/7/2024 12:00:00 AM

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Senior Provider Contract Manager
  • Kaiser Permanente
  • Oakland, CA
  • Description: Job Summary:Manages and conducts specific functions of the contracting and provider relations process. This...
  • 6/7/2024 12:00:00 AM

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Senior Manager-Contract Management, Americas
  • Idaho State Job Bank
  • Boise, ID
  • Senior Manager-Contract Management, Americas at Marriott in Boise, Idaho, United States Job Description Job Number 24034...
  • 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 Manager jobs
$104,523 to $138,809

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