Provider Contracting Executive

Humana

261d • $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 an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial. The Provider Contracting Executive 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 position 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.

Requirements

• 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.
• Demonstrated ability to articulate ideas effectively in both written and oral forms.
• 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.

Nice To Haves

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

Responsibilities

• Initiate, negotiate, and execute provider contracts and agreements.
• 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.
• Assist with identifying and recruiting providers based on network position and needs.
• Advise executives on developing functional strategies.
• Exercise independent judgment and decision making on complex issues.

Benefits

• Health benefits effective day 1.
• Paid time off, holidays, volunteer time and jury duty pay.
• Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance.
• Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree