Strategic Provider Contracting Leader - GA (Medicare/Medicaid)

Humana; Florida; À distance; USD 95 000 - 131 000; Plein temps

Avantages offerts par ce poste

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Short-term disability

Long-term disability

Life insurance

Résumé du poste

Humana Georgia is hiring a Provider Contracting Executive to develop, negotiate, implement, and manage provider network agreements across Georgia. You will lead complex negotiations and build strong relationships with hospitals, physician groups, and other providers to support Medicare Advantage and Medicaid networks, while aligning with affordability, quality, and access goals.

You will collaborate with internal teams to evaluate terms, support value-based models, and ensure compliance with

Qualifications

• Bachelor's degree required.
• 6+ years of progressive network management experience including hospital contracting and network administration.
• 2+ years 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, especially Excel and PowerPoint.
• Ability to travel within Georgia as needed for meetings.

Responsabilités

• Lead provider contracting activity for assigned markets and providers in Georgia.
• Negotiate and execute provider agreements, amendments, renewals, and terminations.
• Develop and maintain relationships with hospitals, physician organizations, and other providers.
• Resolve complex provider issues related to contract interpretation and relationship management.
• Analyze market conditions, provider performance, and reimbursement dynamics to support strategy.
• Partner with internal stakeholders to ensure contracts support affordability, quality, and access.
• Evaluate financial and operational impacts of proposed terms and models.
• Support implementation of value-based arrangements and alternative payment models.
• Ensure contract terms comply with Humana policies and regulations.
• Collaborate with legal, finance, network operations, credentialing, and clinical leadership.

Connaissances

Financial acumen

Analytical skills

Negotiation

Presentation to leadership

Excel

PowerPoint

Travel flexibility

Formation

Bachelor's degree

Outils

Microsoft Excel

Microsoft PowerPoint

Description du poste

Humana Georgia is hiring a Provider Contracting Executive to develop, negotiate, implement, and manage provider network agreements across Georgia. You will lead complex negotiations and build strong relationships with hospitals, physician groups, and other providers to support Medicare Advantage and Medicaid networks, while aligning with affordability, quality, and access goals.

You will collaborate with internal teams to evaluate terms, support value-based models, and ensure compliance with