Strategic Provider Contracting Executive — Remote (GA)

Humana; Lorida (FL); Remote; USD 95,000 - 131,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off

Job summary

Humana Georgia is seeking a Provider Contracting Executive to lead negotiating and managing provider agreements across Georgia, ensuring alignment with network strategy, affordability, and quality goals.

You will build relationships with hospitals and physician groups, analyze market dynamics, and collaborate with legal, finance, and operations to drive value-based contracting and compliant terms.

Qualifications

• Bachelor's degree required.
• 6+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.
• 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

Financial analysis

Analytical skills

Presentation to senior leadership

Microsoft Excel

Microsoft PowerPoint

Education

Bachelor's degree

Master's degree (business, healthcare administration, public health)

Tools

Excel

PowerPoint

Job description

Humana Georgia is seeking a Provider Contracting Executive to lead negotiating and managing provider agreements across Georgia, ensuring alignment with network strategy, affordability, and quality goals.

You will build relationships with hospitals and physician groups, analyze market dynamics, and collaborate with legal, finance, and operations to drive value-based contracting and compliant terms.