Provider Contracting Executive

Profile

Job Information

Humana

Provider Contracting Executive

in

Issaquah

Washington

Description

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

The Provider Contracting Executive is responsible for value based contracting for complex provider systems and negotiates incentive based compensation to motivate provider performance. This position is also responsible for a geographic network, insuring the highest quality of providers available for our members and engaged providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. 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.

Required Qualifications

Bachelor's degree or 8 years of provider/payor managed care contracting experience

8 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

2 or more years 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

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​Medical, religious, state and remote-only work exemptions are available.

Willing to travel 30% within the territory

Preferred Qualifications

Master's Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Existing or Previous Relationships with OR and WA Provider Community.

Additional Information

This role is the highest level of contracting within Humana and will report to a Director

Scheduled Weekly Hours

40

Company info

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