Remote Provider Contracting Executive

Humana; Nashville (TN); Remote; USD 95,000 - 131,000; Full time

Job summary

Humana is seeking a Provider Contracting Executive to lead negotiations and execution of contracts for the Alabama Market. You will be the primary point of contact with providers, communicating terms, payment structures, and reimbursements while analyzing financial impact and maintaining contracts in the tracking system.

You will identify and recruit providers, advise executives on strategic matters, and exercise independent judgment on complex issues, with travel up to 20%.

Qualifications

• 5+ years of progressive network management experience in a healthcare company.
• 2+ 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.

Responsibilities

• Initiate, negotiate, and execute provider contracts for Humana's Alabama Market.
• Communicate contract terms, payment structures, and reimbursement rates to providers.
• Analyze financial impact of contracts and maintain 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.

Skills

Network management

Network administration

Project leadership

Travel up to 20%

Education

Bachelor's Degree

Job description

Humana is seeking a Provider Contracting Executive to lead negotiations and execution of contracts for the Alabama Market. You will be the primary point of contact with providers, communicating terms, payment structures, and reimbursements while analyzing financial impact and maintaining contracts in the tracking system.

You will identify and recruit providers, advise executives on strategic matters, and exercise independent judgment on complex issues, with travel up to 20%.