Humana

Provider Contracting Executive


PayCompetitive
LocationRemote
Employment typeFull-Time

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  • Job Description

      Req#: R-328881

      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.


      Use your skills to make an impact

      Required Qualifications

      • Bachelor's degree

      • 5+ years of negotiating provider contracts including hospital, ancillary and physician contracts

      • 2+ years of value-based contracting experience

      • 2+ 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

      • Candidates must currently reside or be relocating to the states of WI, MO, IL, KS, NE, MN, ND, SD, or IA to be considered

      Preferred Qualifications

      • Master's Degree

      • Experience with ACO/Risk Contracting

      Additional Information

      As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.

      WAH and Internet Guidance

      To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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

      • 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

      Alert:

      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.

      Scheduled Weekly Hours

      40


      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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

  • About the company

      Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs