Provider Contracting Executive

Humana Inc; Atlanta (GA); Remote; USD 95,000 - 131,000; Full time

Job summary

Humana Inc. is seeking a Provider Contracting Executive for the Alabama Market. This remote role requires travel to providers up to 20% and focuses on negotiating and executing contracts, communicating terms, and analyzing financial impact.

The position spans across physician, hospital, and other provider contracts with independent judgment and minimal supervision. Qualified candidates have 5+ years in network management within healthcare, 2+ years in project leadership, and strong contracting

Qualifications

• 5 or more years of progressive network management experience in healthcare.
• 2 or more years of project leadership experience.
• Extensive provider contracting skills including negotiation, preparation and implementation.
• Financial analysis and rate proposal development.
• Must live within the region with travel up to 20%.

Responsibilities

• Initiate, negotiate, and execute physician, hospital, and other provider contracts.
• Primary point of contact with providers and communicate contract terms and reimbursement structures.
• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation in tracking systems.
• Advise executives on functional strategies and travel within the region as needed.

Skills

Network management

Network administration

Project leadership

Contract negotiation

Financial analysis

Rate proposal development

Travel willingness

Education

Bachelor's Degree

ACO/Risk Contracting

Value Based Contracting

Job description

Become a part of our caring community

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

The Provider Contracting Executive will be the primary point of contact with the providers. You will communicate contract terms, payment structures, and reimbursement rates to providers. Analyze financial impact of contracts and terms. Maintain contracts and documentation within a tracking system. Identify and recruit 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 regarding job duties and related tasks, and work under minimal supervision, Use independent judgment requiring analysis of variable factors and determining the best course of action.

Use your skills to make an impact

Required Qualifications

• 5 or more years of progressive network management experience and network administration in a healthcare company
• 2 or more years of project leadership experience
• Extensive provider contracting skills, including contract negotiation, preparation and implementation, financial analysis and rate proposal development
• Must live within the region with the ability and willingness to travel to providers up to 20% of the time

Preferred Qualifications

• Bachelor'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 live within reasonable driving distance of the Alabama region to be considered for this role as you will be required to travel to providers within the region.

Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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.

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.