Provider Contracting Executive

Become a part of our caring community and help us put health first
 The Provider Contracting Executive will be building and servicing hospital networks from the ground up with little direction. In this role, you will initiate, negotiate, and execute physician, ancillary, and/or other provider contracts and agreements for Virginia Medicare and Medicaid providers. The Provider Contracting Executive's work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

• The Provider Contracting Executive negotiates and communicates contract terms, payment structures, and reimbursement rates to providers that are aligned with Humana's financial strategies
• Maintains contracts and documentation within a tracking system
• Identifies and recruits providers based on network composition and needs
• Advises executives to develop functional strategies (often segment specific) on matters of significance
• Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision
• Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Use your skills to make an impact
 

Required Qualifications

• 5 or more years of progressive network management experience working with hospitals, facilities and other large provider practices on recruitment and service activities

• Experienced in negotiating or servicing managed care contracts with large physician groups, ancillary providers and hospitals

• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

• Experience with Medicaid Contracting

• Experience with ACO/Risk Contracting

• Excellent written and verbal communication skills

• Proficiency in MS Office applications

Preferred Qualifications

• Advanced degree (Bachelor's, Master's, JD)

• Experience with Value Based Contracting

Additional Information

This position is considered "remote/work at home", however, the preferred candidate will live within driving distance to providers within the State of Virginia.

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live …