Provider Contracting Executive

Overview

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. 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, using independent judgment requiring analysis of variable factors and determining the best course of action.

• Initiate, negotiate, and execute physician, hospital, and/or other provider contracts and agreements.
• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Analyze the financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• Assist with identifying and recruiting providers based on network composition and needs.
• Advise executives to develop functional strategies (often segment specific) on matters of significance.
• Exercise independent judgment and decision making on complex issues, often under minimal supervision.

• 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
• Must live in South Carolina

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

This role is "remote/work at home", however, you must live/work in South Carolina.

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 required; 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.

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

40

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.

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…