Provider Contracting Executive

Profile

Description

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and path to value agreements. Maintains contracts and documentation within a tracking system. Identifies and recruit 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, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Humana offers industry leading benefits for all employees, starting your FIRST day of employment.

Benefits include:

o Medical Benefits

o Dental Benefits

o Vision Benefits

o Health Savings Accounts

o Flex Spending Accounts

o Life Insurance

o 401(k) with a generous Company match

o PTO including 7 paid holidays, two personal holidays, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

o And more

Required Qualifications

Bachelor's degree

5 years of experience working in the healthcare industry

2 years of project leadership experience

Extensive provider contracting skills, including contract preparation and/or 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

Valid driver's license with the ability to travel within the region up to 20% of the time

Preferred Qualifications

Master's Degree

Experience with hospital contracting

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Additional Information

This position is considered remote/work at home, however, the preferred candidate will be located in the State of Louisiana as you will be required to travel to provider offices within the region up to 20% of the time.

WAH 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

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of COVID-19 vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40

Company info

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