United States onlyBecome a part of our caring community and help us put health first
Humana is seeking a Provider Contracting Manager to join the Wisconsin Medicaid Market (iCare) team. The Provider Contracting Manager will oversee a talented group of Provider Contracting Professionals as they lead change in how health care for the underserved in our society is managed. Share your talents and develop your leadership skills all while doing your part to improve the lives of others.The Provider Contracting Manager will oversee a group of Provider Contracting Professionals who are responsible for initiating, negotiating and executing provider contracts and agreements for Humana’s Wisconsin Medicaid Market (iCare). The Provider Contracting Manager will be responsible for:
- Oversight of contracting professionals in the iCare Medicaid/DSNP WI Market.
- Analyzing financial impact of contracts and terms.
- Maintaining contracts and documentation within a provider data management system.
- Assisting with identifying and recruiting providers based on network composition and needs.
- Making decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
- Collaborating cross-departmentally and conducting briefings and area meetings.
- Maintaining frequent contact with other managers across the organization.
- Preparing, enforcing, and maintaining market policies and procedures that pertain to management of the iCare Provider Network to meet CMS, DHS, and NCQA standards.
- Traveling throughout Wisconsin for provider meetings on a monthly basis.
Use your skills to make an impact
Required Qualifications
- Bachelor’s Degree
- Three (3) or more years of Medicaid contracting experience
- Leadership experience
- Experience interpreting financial trends in the provider contracting arena
- Experience preparing contracts, with an in-depth knowledge of Medicaid and other reimbursement methodologies.
- Two (2) or more years of management experience including supervising and team building
- Excellent written and verbal communication skills and experience presenting to varied audiences
- Proficiency with Microsoft Office applications
- Ability to travel throughout Wisconsin for provider meetings on a monthly basis.
Preferred Qualifications
- Master’s Degree
- In-depth knowledge of NCQA requirements in relation to network standards
- Familiarity with Long Term Care contracting
- Experience with ACO/Risk Contracting
- Value based contracting experience
Additional Information
- Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
- Travel: up to 15% within the state of Wisconsin for provider meetings
- Typical Work Days/Hours: Monday through Friday; 8:30am – 5:00 pm (CST)
- Direct Reports: 6-8
WAH Internet Statement
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.
Driving
This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100/300/100 limits.
Benefits
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
HireVue
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.
SSN 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.
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.$94,900 - $130,500 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 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.
