Home
/
Comprehensive
/
Provider Contracting Professional
Provider Contracting Professional-December 2024
Boston
Dec 15, 2025
ABOUT HUMANA
At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized whole-person healthcare experiences.
10,000+ employees
Healthcare
VIEW COMPANY PROFILE >>
About Provider Contracting Professional

  Become a part of our caring community and help us put health first

  The Provider Contracting Professional 2 initiates, negotiates, and executes physician, hospital, 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.

  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

  Our Department of Defense Contract requires U.S. Citizenship

  Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

  Bachelor's degree or relevant provider contracting experience

  HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.

  2 years of experience in negotiating managed care contracts with physician, hospital, ancillary and/or other provider contracts or provider contracting experience

  Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers

  Proficiency in MS Office applications

  Excellent written and verbal communication skills

  Ability to manage multiple priorities in a fast-paced environment

  Detail oriented

  Must be available to work an 8 hour shift Monday - Friday 8:00 am - 5:00 pm in the Eastern or Central Times Zone schedule - due to the needs of the business you may be required to be flexible with your work hours

  Preferred Qualifications

  Value Based Contracting knowledgeScheduled 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 yearThis 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.

  Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Specialized Travel Consultant
Amex GBT is a place where colleagues find inspiration in travel as a force for good and – through their work – can make an impact on our industry. We’re here to help our colleagues achieve success an
Laminator I - Weekend (Fri/Sat/Sun)
We are continuing to grow! We are currently accepting applications for an upcoming Weekend Shift Assembly Technician (Laminator) need at our Renton location.Assembly Technician Level I (Laminator I)L
Guest Service Agent - Overnight - Kimpton Palladian Hotel
Night Auditor Palladian Hotel Kimpton Hotels & Restaurants Belltown Seattle The hourly pay for this role is $22.00. This range is only applicable for jobs to be performed in Seattle, WA. This is
Licensed Practical Nurse (LPN)
The Elk County Prison is seeking a contracted LPN able to work rotating 7pm-10pm Monday through Friday and/or 8am -12pm and 7pm-10pm on weekends at a rate of $24.94 per hour. This position requires t
Audit & Reimbursement II
WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Elevance Health requires a completed online app
John Deere Field Service Technician
C & B Equipment, a progressive family-owned company that has grown over 30 years to include John Deere Ag, material handling and power sports locations, has an opening for a Field Service Technic
Retail Merchandiser
Job Posting CROSSMARK is seeking a fun, energetic part-time Merchandiser who enjoys staying active in a fast-paced environment. You would be responsible for engaging and captivating consumers by time
Intern Global Transaction Advisory Group (TAG) - 202203152-OTHLOC-Cj1bYfwd
Description About AandM Companies, investors and government entities around the world turn to Alvarez and Marsal (AandM) for leadership, action and results. Privately held since its founding in 1983,
QUALITY CONTROL IN-PROCESS INSPECTOR
JOB SUMMARY Under the direct supervision of the Quality Director with input from the Quality Manager the Quality In-Process Inspector is responsible for assuring production parts are inspected by the
Staff Nurse II -32 Hours - Day
Job Summary: The Registered Nurse (RN) II is a professional caregiver who assumes responsibility and accountability for a group of patients for a designated time frame. The RN II provides care to pat
Copyright 2023-2025 - www.zdrecruit.com All Rights Reserved