Provider Contracting Executive

Humana • Washington, NV

6d • Remote

About The Position

The Provider Contracting Executive executes physician, hospital, and other provider contracts and agreements for organizations that provide health insurance. The Provider Contracting Executive will support the Nevada and Hawaii market and works on problems of diverse scope and complexity ranging from moderate to substantial, reporting directly to the Provider Contracting Director.

Requirements

• At least 5+ years of health care or managed care experience with focus in Provider Contracting, Network Management or Provider Relations.
• 2+ years of demonstrated project management experience and partnering with senior leadership on strategic initiatives.
• 2+ years of value-based contracting.
• 2+ years of facility and ancillary contracting.
• Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Experience managing various projects simultaneously.
• Ability to travel as needed.
• Must work Pacific Standard Time (PST).

Nice To Haves

• Bachelor's degree in business, healthcare administration, finance, or a related field.
• Experience and comfort with contract management systems.
• Knowledge of Medicare Stars and HEDIS measures.
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance.
• Comprehensive knowledge of Medicare policies, processes and procedures.
• Resides in AZ, CA, HI, NM, NV, OR, or WA.

Responsibilities

• Prepare and communicate contract terms, payment structures, and reimbursement rates to providers.
• Analyze the financial impact of contracts and contract terms.
• Maintain contracts and related documentation within a tracking system.
• Identify and recruit providers based on network composition and needs.
• Advise executives on developing functional strategies (often segment-specific) for significant matters.
• Use your skills to make an impact.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior