Provider Contracting Executive

Position Overview

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.

Responsibilities

• 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.
• Works under minimal supervision and uses independent judgment requiring analysis of variable factors and determining the best course of action.

Requirements

• Required Qualifications:
  • Bachelor's degree
  • 8 or more years of progressive network management experience including increasingly complex hospital and integrated delivery network contracting and network administration in a healthcare company.
  • 2 or more years of project leadership experience.
  • Experience with Value Based and Risk Based Contracting.
  • 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 senior leadership.
  • Ability to manage multiple priorities in a fast-paced environment.
  • Knowledge of Microsoft Office applications with specific focus on using and understanding Excel data.
  • Must be passionate about contributing to an organization focused on continuously improving provider and member experiences.
• Preferred Qualifications:
  • Master's Degree
  • Experience with Risk Based Contracting with ACO.

Employment Type

• Full time

Location Type

• [Information not specified]

Salary

• [Information not specified]

Additional Information

• Travel: Up to 20% or based upon business need. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
• Interview Technology: As part of our hiring process for this opportunity, we will be using an 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.
• Work At Home / Internet Information:
  • 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 required; 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.
• SSN Information: 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.

Company Information

• [Information not specified]