Provider Contracting Director jobs in Springfield, MO

Provider Contracting Director is responsible for the operations of the provider contracts department. Ensures that provider contracts are processed to support accurate and efficient claims payments. Being a Provider Contracting Director oversees the formulation of provider contracts and specific terms. Analyzes contract data and provides financial projections. Additionally, Provider Contracting Director requires a bachelor's degree. Typically reports to top management. The Provider Contracting Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Provider Contracting Director typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Director, Provider Contracting
  • Humana
  • Springfield, MO FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the region of Kansas City and Nebraska. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

    The Director, 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 the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's Degree

    • 5 years of extensive provider contracting experience inclusive of all provider types

    • Proven leadership experience, including teambuilding

    • Comfortable with hiring and building teams

    • Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies

    • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

    • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

    • Applicant must be located in one of the following states: NE, MO, or KS

    Preferred Qualifications

    • Master's or J.D. Degree
    • Experience with ACO/Risk Contracting
    • Value based contracting experience

    Additional Information

    • Work at Home Requirements

      • Must have the ability to provide a high speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role). Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
      • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. 
      • A dedicated space conducive to learning and keeping protected health information (PHI / HIPAA) of our members confidential. Your designated work location must be located away from other household distractions, including but not limited to ensuring that alternate caregiving arrangements are made for dependents or other members in the household.

      • As part of our hiring process for this opportunity, we will be using an exciting 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.  If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone, and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

      • Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at 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.


     

    $136,200 - $187,400 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.

  • 17 Days Ago

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Housing Specialist
  • Housing provider
  • Joplin, MO FULL_TIME
  • LOCAL HOUSING provider is seeking a full-time clerical person.Responsibilities include assisting in the review and verification of applications for public housing, along with exercising considerable j...
  • 17 Days Ago

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RN Care Coordinator
  • Provider Partners Health Plan
  • Lebanon, MO FULL_TIME
  • RN Care Coordinator POSITION SUMMARY * NO CALL* The Nurse Care Coordinator will play a key role in the execution of the Provider Partners Health Plan (PPHP) Model of Care (MOC) through the collaborati...
  • 1 Month Ago

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RN Care Coordinator
  • Provider Partners Health Plan
  • Springfield, MO FULL_TIME
  • RN Care Coordinator POSITION SUMMARY * NO CALL* The Nurse Care Coordinator will play a key role in the execution of the Provider Partners Health Plan (PPHP) Model of Care (MOC) through the collaborati...
  • 1 Month Ago

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System Contracting Lead IT
  • CoxHealth
  • Springfield, MO FULL_TIME
  • Summary Best in Class Work Environment 5x Modern Healthcare Best Places to work America’s Greatest Workplaces 2023 – Newsweek Best Employers for New Grads 2023- Forbes Greatest Workplace for Women 202...
  • 10 Days Ago

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General Service Attendant - SBU
  • PROVIDER CONTRACT FOOD SERVICE INC
  • BOLIVAR, MO FULL_TIME
  • DescriptionAbout Us:Provider Contract Food Service specializes in providing culinary and hospitality excellence to our clients for the past 18 years. Our location at Southwestern Baptist University in...
  • 19 Days Ago

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0 Provider Contracting Director jobs found in Springfield, MO area

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Clinical Provider
  • Burrell Behavioral Health
  • Springfield, MO
  • Job Description: CLINICAL PROVIDER What you'll get to do: Provide individual, group, family and/or other practical couns...
  • 4/22/2024 12:00:00 AM

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School Based Therapist (Springfield)
  • Burrell Behavioral Health
  • Springfield, MO
  • Job Description: School Based Therapist Springfield, Missouri area Are you a licensed or provisionally licensed therapis...
  • 4/22/2024 12:00:00 AM

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Post Doc Psychologist
  • Jordan Valley Community Health Center
  • Springfield, MO
  • Post Doctorate - Psychologist - Fulltime, 36-hour workweek Provide crisis management, individual and family psychologica...
  • 4/21/2024 12:00:00 AM

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Licensed Clinical Therapist - Outpatient Services (Columbia or Remote)
  • Burrell Behavioral Health
  • Bolivar, MO
  • Job Description: OUTPATIENT THERAPIST $3,000 SIGN ON BONUS * REMOTE WORK FROM HOME AVAILABLE * BURRELL IS HRSA-NHSC APPR...
  • 4/20/2024 12:00:00 AM

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Licensed Clinical Therapist - Outpatient Services (Columbia or Remote)
  • Burrell Behavioral Health
  • Republic, MO
  • Job Description: OUTPATIENT THERAPIST $3,000 SIGN ON BONUS * REMOTE WORK FROM HOME AVAILABLE * BURRELL IS HRSA-NHSC APPR...
  • 4/19/2024 12:00:00 AM

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Licensed Clinical Therapist - Outpatient Services (Columbia or Remote)
  • Burrell Behavioral Health
  • Ash Grove, MO
  • Job Description: OUTPATIENT THERAPIST $3,000 SIGN ON BONUS * REMOTE WORK FROM HOME AVAILABLE * BURRELL IS HRSA-NHSC APPR...
  • 4/19/2024 12:00:00 AM

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Post Doc Psychologist
  • Jordan Valley Community Health Center
  • Springfield, MO
  • Post Doctorate - Psychologist - Fulltime, 36-hour workweek Provide crisis management, individual and family psychologica...
  • 4/18/2024 12:00:00 AM

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Licensed Clinical Therapist - Outpatient Services (Columbia or Remote)
  • Burrell Behavioral Health
  • Forsyth, MO
  • Job Description: OUTPATIENT THERAPIST $3,000 SIGN ON BONUS * REMOTE WORK FROM HOME AVAILABLE * BURRELL IS HRSA-NHSC APPR...
  • 4/18/2024 12:00:00 AM

Springfield is the third-largest city in the state of Missouri and the county seat of Greene County. As of the 2010 census, its population was 159,498. As of 2017, the Census Bureau estimated its population at 167,376. It is the principal city of the Springfield metropolitan area, which has a population of 462,369 and includes the counties of Christian, Dallas, Greene, Polk, Webster. Springfield's nickname is "Queen City of the Ozarks" and it is known as the "Birthplace of Route 66". It is home to three universities, Missouri State University, Drury University, and Evangel University. Springf...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Director jobs
$155,092 to $223,994
Springfield, Missouri area prices
were up 1.3% from a year ago

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