Manager Provider Contracting

Profile

Description

Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole.

Responsibilities

The Manager, Provider Contracting 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. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.

Required Qualifications


Bachelor's Degree
6 or more years of progressive contracting experience for a national health plan including hospital contracting
2 or more years of management experience including supervising and team building
Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
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
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Master's Degree
Experience with ACO/Risk Contracting
Value based contracting experience


We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.

Scheduled Weekly Hours

40

Company info

Sign Up Now - WashingtondcCrossing.com