Provider Contracting Executive

Become a part of our caring community and help us put health first
 The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Provider Contracting Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. This individual analyzes financial impact of contracts and terms. This individual maintains contracts and documentation within a tracking system. This individual may assist with identifying and recruiting providers based on network composition and needs. This individual advises executives to develop functional strategies (often segment specific) on matters of significance. This individual uses independent judgment and decision making on complex issues regarding job duties and related tasks and works under minimal supervision. This individual uses independent judgment requiring analysis of variable factors and determining the best course of action.

Use your skills to make an impact
 

Required Qualifications

• Our Department of Defense Contract requires U.S. citizenship for this position

• Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

• Minimum 5 years of progressive network management experience with - IPA’s, PHO’s, multi-state hospital systems and national ancillary providers and network administration in a healthcare company

• Strong experience with Value Based and Risk Contracting

• Ability to manage multiple priorities in a fast-paced environment.

• Extensive provider contracting skills, including contract preparation and implementation, strong financial acumen with proficiency in analysis of rate proposal development

• Excellent written and verbal communication skills and experience presenting to varied audiences

• Knowledge of Microsoft Office applications

Work-At-Home Requirements

• At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

• Undergraduate Degree

• Minimum 2 years of project management experience

• Experience with ACO contracting

• Experience with military contracting

Additional Information

• HGB is not authorized to do …