Strategic Provider Contracting Executive (GA)

Humana Inc; Georgia (VT); Remote; USD 95,000 - 131,000; Full time

Benefits offered by this job

Bonus incentive plan

Comprehensive benefits

Job summary

Humana Georgia is seeking a Provider Contracting Executive to lead negotiations and management of provider network agreements across Georgia for Medicare Advantage and Medicaid programs. You will build relationships with hospitals, physician groups, and health systems, ensuring contracts support affordability, quality, and member access.

You will analyze market conditions, collaborate across internal teams, and drive value-based arrangements while ensuring compliance with Humana policies.

Qualifications

• Bachelor's degree in a relevant field.
• 6+ years of progressive network management experience in healthcare.
• 2+ years of supporting providers in value-based arrangements.
• Knowledge of provider reimbursement methodologies, including fee-for-service and value-based models.
• Strong financial, analytical, and negotiation skills.
• Experience presenting to Senior leadership.
• Proficiency with Microsoft Office applications, especially Excel and PowerPoint.
• Ability to travel within Georgia as needed for provider meetings, department meetings, and market support.

Responsibilities

• Lead provider contracting activity for assigned markets, providers, and provider types within Georgia.
• Negotiate and execute provider agreements, amendments, renewals, and terminations in alignment with enterprise network strategy.
• Develop and maintain productive relationships with hospitals, physician organizations, ancillary providers, and health systems.
• Resolve complex provider issues related to contract interpretation, escalations, and relationship management.
• Analyze market conditions, provider performance, reimbursement structures, utilization trends, and competitive dynamics to support contracting strategy.
• Partner with internal stakeholders to ensure provider contracts support affordability, quality, network adequacy, growth, and member access objectives.
• Evaluate financial and operational impacts of proposed contract terms and reimbursement models.
• Support implementation of value-based arrangements and alternative payment models where applicable.
• Ensure contract terms comply with Humana policies, state and federal regulations, and internal governance requirements.
• Collaborate with matrixed teams including legal, finance, network operations, credentialing, provider engagement, and clinical leadership

Skills

Negotiation

Relationship management

Market analysis

Financial acumen

Contract execution

Collaboration

Regulatory awareness

Problem-solving

Education

Bachelor's degree

Tools

Microsoft Office

Excel

PowerPoint

Job description

Humana Georgia is seeking a Provider Contracting Executive to lead negotiations and management of provider network agreements across Georgia for Medicare Advantage and Medicaid programs. You will build relationships with hospitals, physician groups, and health systems, ensuring contracts support affordability, quality, and member access.

You will analyze market conditions, collaborate across internal teams, and drive value-based arrangements while ensuring compliance with Humana policies.