The Provider Contracting Professional (Dental Network) initiates, negotiates, and executes dental provider contracts and agreements for the organization. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.The Provider Contracting Professional (Dental Network) communicates contract terms, payment structures, and reimbursement rates to providers. Analyze financial impact of contracts and terms. Maintain contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receive guidance where needed. Follow established guidelines/procedures. Prioritization of leads, fee schedule reimbursement, needed travel for in person dental office visits, research of local community events and how Humana can support these events, identification of local dental society sponsorship opportunities and assisting providers with a variety of issues. Examples include; identifying which fee schedule to offer and also negotiating to determine the value of the provider to all Humana customers based on the compensation.
Meet with Dental Providers face-to-face.
Use your skills to make an impact
Required Qualifications
2 - 5 years of experience negotiating managed care contracts with physician, hospital and/or other provider contracts.
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
This role is part of Humana's Driver safety program and therefore requires you to have a valid state driver's license and proof of personal vehicle liability insurance
Travel is required up to a minimum 20%Preferred Qualifications
Bachelor's degree
Master's Degree
Experience with ACO/Risk Contracting
Experience with Value Based Contracting# LI-KR1
Work at Home RequirementsTo 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.$65,000 - $88,600 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.