Role: Contract Specialist Assignment: National Contracting Location:New York, NY or Work at Home Anywhere U.S.
We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our providers, consumers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our providers, members, employers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.
Assignment Capsule The Contract Specialist will coordinate the end-to-end setup of provider contracts. Ensure data integrity and maintenance of the contracts.
Maintains contracts, including making changes and updates using various systems i.e. network add and deletes. Changes can include:
o Translate provider needs to change information into system request (i.e. demographic changes) o Request for TIN Changes - change TIN for individual providers and/or entire group, join a group or move groups o Request for Specialty Changes o Request for Adding Physician to Existing Practice, or request for Terminations from providers research and cleaning up dated information o IPA Updates (adds/terms/changes to groups) o Add a Physician Extender
In some markets, complete set up for delegation of credentialing and any provider network data needed for other forms of delegation.
Executes for Results, Accountability, Builds Trust, Interpersonal Effectiveness
High School Degree or equivalent
Valid driver’s license and/or dependable transportation necessary
Experience with Humana network contract systems (e.g. Service Fund, CAS, Apex, MTV) Reporting Relationships
This position reports to a Contracting Director.
Additional Information Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
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Title: Provider Contract Specialist
Location: New York-New York
Requisition ID: 178717