Provider Contracting Executive

Humana • Work at Home - Alabama, TN

3d • $94,900 - $130,500 • Remote

About The Position

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for Humana's Alabama Market. The Provider Contracting Executive will be the primary point of contact with the providers. You will communicate contract terms, payment structures, and reimbursement rates to providers. Analyze financial impact of contracts and terms. Maintain contracts and documentation within a tracking system. Identify and recruit providers based on network composition and needs. Advise executives to develop functional strategies (often segment specific) on matters of significance. Exercise independent judgment and decision making on complex issues regarding job duties and related tasks, and work under minimal supervision, Use independent judgment requiring analysis of variable factors and determining the best course of action.

Requirements

• 5 or more years of progressive network management experience and network administration in a healthcare company
• 2 or more years of project leadership experience
• Extensive provider contracting skills, including contract negotiation, preparation and implementation, financial analysis and rate proposal development
• Must live within the region with the ability and willingness to travel to providers up to 20% of the time
• Self-provided internet service with at least a download speed of 25 Mbps and an upload speed of 10 Mbps
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Bachelor's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements.
• Serves as the primary point of contact with providers.
• Communicates contract terms, payment structures, and reimbursement rates to providers.
• Analyzes the financial impact of contracts and terms.
• Maintains contracts and documentation within a tracking system.
• Identifies and recruits providers based on network composition and needs.
• Advises executives to develop functional strategies on matters of significance.
• Exercises independent judgment and decision making on complex issues.
• Works under minimal supervision.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree