Humana Contract Administrator in Tulsa, Oklahoma
Role: Contract Administrator Assignment: National Contracting *Location: *Tulsa, OK or Kansas City area
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 Administrator will manage the end-to-end setup of complex provider contracts. Ensure data integrity and maintenance of the contracts.
Ensures contracts are operationalized from contracting through implementation, leveraging standardized tools and quality processes end to end.
Defined point of contact for Contracting and Provider Service (DCAV, PPG, Credentialing, Service Fund) regarding contract administration, data integrity, testing/auditing, maintenance (including annual escalators) attributions and contract clarifications for more complex contracts. This may include path-to-value and value-based contracts.
Support Humana’s providers and communicate with Humana’s clients in order to facilitate greater physician understanding and cooperation during the contracting process.
Maintains contracts, including making changes and updates using various systems i.e. network add and deletes. Collaborates with Provider Engagement Executive or Consultant to complete reassignment of membership.
Ensures initial credentialing, managing unresponsive providers through re credentialing, and resolves discrepancies.
Test contract performance before operationalizing and perform audits to optimal standards for prevention. May lead/oversee testing and/or auditing of contracts by other associates.
(In some markets) Complete system set up for delegation of credentialing and any provider network data needed for other forms of delegation. Manage delegated relationship data: credentialing, UM, claims.
Manage operational issues with IDS, Specialists, and key Providers.
Work with Contract Directors to assist with and follow up on routine provider contracts.
High School Degree or equivalent
Proficiency in MS Office applications
Possess a strong attention to detail
Ability to work in a deadline driven environment
Strong verbal and written communication skills
Previous account management, project management or related experience
Valid driver’s license and/or dependable transportation necessary Role Desirables
Associate’s or Bachelor’s Degree
Prior experience working in the insurance industry
Proficiency in MS Access
Previous experience in claims
Prior contract interpretation experience strongly desired
Previous provider experience (provider contract, provider relations, or provider service) 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.
Title: Contract Administrator
Other Locations: US-Kansas-Overland Park
Requisition ID: 190335
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.