Contract Tools Education Processes Lead

Profile

Description

The Contract Tools, Education, Processes Lead builds templates, standard documentation, policy and protocol, reviews contracts, and disseminating best in class knowledge. The Contract Tools, Education, Processes Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Contract Tools, Education, Processes Lead Advises executives to develop functional strategies 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.

Manages the modernization of provider contract template(s).

Assists markets with meeting strategic goals by ensuring standard language meets their needs.

Analyze reimbursement methodologies and rates compared to peers and other contracted providers while providing strategic direction to market management for potential implementation.

Ability to manage and bring highly visible projects to closure.

Ensure Humana provider contracting migrates to standardization to ensure state and federal compliance and Humana business goals can be implemented.

Required Qualifications

Bachelor's Degree

5 or more years of experience working with provider and/or vendor contracting

Strong understanding of reimbursement methodologies, language, and strategies

Experience writing and contributing to the Provider Contracting Guidelines Manual

Possesses a solid understanding of how organization capabilities interrelate across department(s)

Experience leading projects

Experience working in a matrix-oriented environment

Strong oral and written communication skills

Flexible, dynamic personality who works well in a team environment

Work-At-Home Requirements

Must have the ability to provide a high speed DSL or cable modem for a home office. 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.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com