Provider Contracting Executive

Humana • Arlington, TX

1d • Remote

About The Position

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. This role involves working on problems of diverse scope and complexity, ranging from moderate to substantial. The executive communicates contract terms, payment structures, and reimbursement rates to providers, and analyzes the financial impact of contracts and terms. They are responsible for maintaining contracts and documentation within a tracking system and may assist with identifying and recruiting providers based on network composition and needs. The position advises executives to develop functional strategies on matters of significance, exercises independent judgment and decision-making on complex issues regarding job duties and related tasks, and works under minimal supervision, requiring analysis of variable factors to determine the best course of action.

Requirements

• Bachelor's degree
• 8 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
• Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development
• Knowledge of healthcare provider reimbursement structures
• Excellent written and verbal communication skills and experience presenting to varied audiences
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency with Microsoft Office applications

Nice To Haves

• Master's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting
• 2 or more years of project leadership experience

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance
• 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, Uses independent judgment requiring analysis of variable factors and determining the best course of action

Benefits

• Medical benefits
• Dental benefits
• 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 disability
• Long-term disability
• Life insurance
• Bonus incentive plan

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Number of Employees: 5,001-10,000 employees