FreshRemote.Work

Provider Contracting Executive

Work at Home - Nebraska, United States

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. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting 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.


Use your skills to make an impact
 

Required Qualifications

  • 8 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

  • 2 or more years of project leadership experience

  • Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development

  • Demonstrated ability to articulate ideas effectively in both written and oral forms

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

  • Knowledge of Microsoft Office applications

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Bachelor’s Degree

  • Experience with ACO/Risk Contracting

  • Experience with Value Based Contracting

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Benefits Information:

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

Work At Home / Internet Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • 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

  • Employees 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 employees 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

SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


 

$94,900 - $130,500 per year


 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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Job Profile

Regions

North America

Countries

United States

Restrictions

California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Home office setup required Illinois Montana Must meet internet speed requirements Occasional travel Remote position South Dakota Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota

Benefits/Perks

401k retirement 401k Retirement Savings 401(k) with match Bonus Incentive Bonus incentive plan Career development Career development opportunities Caring community Competitive benefits Dental Disability Employee charity matching Employee charity matching program Financial Security Flexible packages Health benefits Health benefits effective day 1 Healthcare decisions Health first Health insurance Holidays Jury duty pay Life Life Insurance Medical Occasional travel Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Recognition pay Remote position Scholarships Scholarships for eligible dependents Smart healthcare decisions Support whole-person well-being Time off Tuition Assistance Variety of benefits Vision Vision Benefits Volunteer time Volunteer time off Whole-person well-being Work From Home

Tasks
  • Advise executives
  • Analysis
  • Analyze financial impact
  • Decision making
  • Design
  • Develop functional strategies
  • Documentation
  • Financial analysis
  • Maintain documentation
  • Manage multiple priorities
  • Negotiate contracts
  • Proposal development
  • Recruit providers
  • Training
Skills

Analysis Articulate Assist BI Business Communication Compensation Consumer Experiences Contracting Contract Negotiation Contract preparation Decision making Dental Design Documentation Education Financial analysis Functional strategies Health benefits Healthcare Healthcare services Health Insurance HIPAA HireVue Implementation Insurance Interviewing IT Leadership Life Insurance Management Medicaid Medicare Microsoft Microsoft Office Microsoft Office Applications Network Network administration Network management Organization Policy Project leadership Proposal Development Provider Contracting Recruiting Recruitment Risk Risk contracting Security Supervision Support Technology Training Travel Vision Wellness

Experience

8 years

Education

Associate Bachelor Bachelor's degree Business Education Healthcare Higher IT Management

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9