The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

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
• 5 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
• Excellent written and verbal communication skills and experience presenting to varied audiences
• Ability to manage multiple priorities in a fast-paced environment
• Knowledge of Microsoft Office applications

Preferred Qualifications

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

Additional Information

This position is considered "remote/work at home", however, you must work within the Eastern Time Zone to be considered for this opportunity.

Work at Home Information

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• 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
• Associates 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 associates 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

Scheduled Weekly Hours

40