Provider Contracting Executive

Become a Part of Our Caring Community and Help Us Put Health First

The Contracting Executive will be responsible for setting VBC / APM contracting strategies within an assigned geographical region and executing upon said strategy. 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.

Key Accountabilities

55% The Contracting Executive role will maintain responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to meet and exceed for providers to gain additional payments. Cross team collaboration will be essential within HGB between, the Contracting Executive role, Actuary, Market Field Leadership, and Executive Council in order to ensure goals are met. Will also influence the field in terms of which systems to partner with, provide sound contracting strategy as well as contract template development, which will require expertise, creativity in their approach, keen sense of negotiating, and a steadfast, pragmatic approach in order to ensure we improve the care of the TRICARE beneficiaries.

25% Works with senior executives on the development of functional strategies (often segment specific) and provides recommendations to senior executives on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under nominal supervision. Employs strategic thinking analysis of multiple and variable factors determining the best course of action. Utilizes considerable latitude in determining task objectives and approaches to completing assignments to meet goals and set deadlines.

10% Advanced subject matter expert, highly competent able to work at very high levels in multiple knowledge and functional areas across multiple departments.

10% 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 analysis and recruitment of providers based on network deficiencies, composition and needs.

Use Your Skills to Make an Impact

Required Qualifications

• Our Department of Defense Contract requires U.S. citizenship for this position
• Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
• HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
• Bachelor's Degree
• 5 years of experience with Value Based Contracting
• 3 years of experience with provider contracting skills including contract preparation and implementation, strong financial acumen with proficiency in analysis of rate proposal development
• Experience presenting to varied audiences

Preferred Qualifications

Work at Home Requirements

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 The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $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. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.