Provider Contracting Manager jobs in Green Bay, WI

Provider Contracting Manager manages the activities of the contracting staff that prepare and maintain contracts and the contracts database system for a health plan network. Responsible for negotiating with facilities joining the health network and setting rates. Being a Provider Contracting Manager oversees network reporting requirements to ensure compliance with regulatory agencies, and to produce accurate and relevant reporting of data. Trains and develops staff. Additionally, Provider Contracting Manager requires a bachelor's degree. Typically reports to a head of a unit/department. The Provider Contracting Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Provider Contracting Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Provider Contracting Executive
  • Humana
  • Green, WI FULL_TIME
  • Become a part of our caring community and help us put health first
     

    The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

    The Provider Contracting Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.


    Use your skills to make an impact
     

    Required Qualifications

    • Bachelor's degree

    • 5 years of negotiating provider contracts including hospital, ancillary and physician contracts

    • 2 years of value-based contracting experience

    • 2 of project leadership experience

    • Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development

    • 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

    • Candidates must currently reside or be relocating to the states of WI, MO, IL, KS, NE, MN, ND, SD, or IA to be considered

    Preferred Qualifications

    • Master's Degree

    • Experience with ACO/Risk Contracting

    Additional Information

    As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.

    WAH and Internet Guidance

    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

    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.

    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.


     

    $93,000 - $128,000 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.

  • Just Posted

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Service provider
  • Goodwill Industries of Northern WI and Upper MI
  • Marinette, WI FULL_TIME
  • Responsible for providing support and assistance, individually and / or in a group setting, to clients within our community and within our Goodwill Possibilities Work Center. Responsible for the super...
  • 16 Days Ago

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Childcare Provider
  • Forever Young Childcare Center, LLC
  • Green, WI PART_TIME,FULL_TIME
  • Job Summary:We are seeking a dedicated Childcare Provider to join our team and a be a part of the #1 TOP RATED CHILDCARE CENTER in the state of Wisconsin! The ideal candidate will have experience in v...
  • 6 Days Ago

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Childcare Provider
  • Northern Lights YMCA-Dickinson Center
  • Escanaba, MI FULL_TIME
  • Overview:We are seeking a dedicated and experienced Childcare Provider to join our team. As a Childcare Provider, you will play a crucial role in nurturing and caring for children in a safe and suppor...
  • 13 Days Ago

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Provider Relations - Brown County
  • AssuranceSD
  • Green, WI FULL_TIME
  • AssuranceSD is a mission-driven organization providing administrative services that enable individuals to take ownership over their personal care services, ensuring that they receive quality and compr...
  • 17 Days Ago

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AUDIOLOGY PROVIDER-URGENT NEED
  • Veterans Evaluation Services-Veterans Affairs
  • Mountain, MI PART_TIME,CONTRACTOR,TEMPORARY
  • URGENT NEED FOR PROVIDER TO SEE VETERANS IN THEIR OWN FACILITY! ADDITIONAL INCOME STREAM!! Seeking a Audiology Provider (Au.D, M.A., M.S., Ph.D, MCD, Ed.D) within 100 miles of Iron Mountain, MI. Veter...
  • 17 Days Ago

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0 Provider Contracting Manager jobs found in Green Bay, WI area

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Administrative Assistant - USDA
  • Heartland Consulting
  • Green Bay, WI
  • Job Description Job Description Duties Properly processing a Farm Bill application, administrative support for ranking, ...
  • 4/25/2024 12:00:00 AM

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Senior Service Delivery Manager
  • HCLTech
  • Appleton, WI
  • Job Title : Service Delivery Manager Location : Appleton, Wisconsin Job Type : Fulltime permanent Job Purpose: Service D...
  • 4/25/2024 12:00:00 AM

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Manager, Business Operations
  • Jack Schroeder And Associates Llc
  • De Pere, WI
  • Job Summary The Manager of Business Operations provides support to the executive leadership team; performing a variety o...
  • 4/25/2024 12:00:00 AM

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In-House Attorney (Contracts and Intellectual Property)
  • Confidential
  • Appleton, WI
  • POSITION SUMMARY The In-House Attorney specializes in contracts and intellectual property (IP). The ideal candidate will...
  • 4/23/2024 12:00:00 AM

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Project Manager
  • LaForce
  • Green Bay, WI
  • Electronic Security Systems powered by LaForce, has an opportunity for a Security Integration Project Manager in our Gre...
  • 4/23/2024 12:00:00 AM

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F&I Manager
  • Camping World
  • Green Bay, WI
  • Job Description Camping World Holdings, Inc., headquartered in Lincolnshire, IL, (together with its subsidiaries) is Ame...
  • 4/22/2024 12:00:00 AM

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In-House Attorney (Contracts and Intellectual Property)
  • Confidential
  • Appleton, WI
  • POSITION SUMMARY The In-House Attorney specializes in contracts and intellectual property (IP). The ideal candidate will...
  • 4/21/2024 12:00:00 AM

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Assistant Manager- Bellevue
  • Valvoline Instant Oil Change
  • Bellevue, WI
  • What You'll Do: As an Assistant Manager, you are the right hand of the Service Center Manager. You are responsible for t...
  • 4/15/2024 12:00:00 AM

Green Bay is a city in and the county seat of Brown County in the U.S. state of Wisconsin, at the head of Green Bay, a sub-basin of Lake Michigan, at the mouth of the Fox River. It is 581 feet (177 m) above sea level and 112 miles (180 km) north of Milwaukee. The population was 104,057 at the 2010 census. Green Bay is the third-largest city in the state of Wisconsin, after Milwaukee and Madison, and the third-largest city on Lake Michigan's west shore, after Chicago and Milwaukee. Green Bay is home to the National Football League's Green Bay Packers. Green Bay is the principal city of the Gree...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Contracting Manager jobs
$104,154 to $138,317
Green Bay, Wisconsin area prices
were up 1.3% from a year ago

Provider Contracting Manager in Scranton, PA
In order to properly oversee provider contracts, insurance companies must ensure all the medical professionals they are contracting with are properly credentialed; maintain detailed price sheets to standardize how much they are paying for services; and keep historical records of each account.
December 11, 2019
Provider Contracting Manager in Allentown, PA
The complete report provides the full listing of all companies nominated, as well as benchmark ratings for a listing of 40+ companies in account support and contracting.
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Provider Contracting Manager in Savannah, GA
The Senior Provider Contract Manager is responsible for developing, negotiating, managing and leading complex contractual, legal and financial arrangements with providers that ensure CCA members have superior access to the highest quality, cost-effective providers of healthcare services.
January 03, 2020