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Provider Contracting Executive

Provider Contracting Executive

HumanaLouisville, KY, US
4 days ago
Job type
  • Full-time
Job description

Provider Contracting Executive

Become a part of our caring community and help us put health first. 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 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.

Required Qualifications

  • Bachelor's Degree
  • 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

Preferred Qualifications

  • Master's Degree
  • Managed Care Contracting experience
  • Experience with ACO / Risk Contracting
  • Experience with Value Based Contracting
  • Additional Information

    As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

    Work At Home / Internet Information :

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
  • Satellite, cellular and microwave connection can be used only if approved by leadership
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
  • SSN Information : Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

    Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

    Scheduled Weekly Hours 40

    Pay Range $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

    Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.

    About Us

    Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

    Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.

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    Provider Contracting • Louisville, KY, US

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