Provider Contracting Executive

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About the role

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. This role communicates contract terms, payment structures, and reimbursement rates to providers, analyzes the financial impact of contracts and terms, and 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 on matters of significance.

Responsibilities

• Initiate, negotiate, and execute provider contracts and agreements
• Communicate contract terms, payment structures, and reimbursement rates to providers
• Analyze financial impact of contracts and terms
• Maintain contracts and documentation within a tracking system
• Assist with identifying and recruiting providers based on network needs
• Advise executives on functional strategies

Requirements

• 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company
• 2+ years of project leadership experience
• Extensive provider contracting skills, including contract negotiation, preparation, implementation, financial analysis, and rate proposal development

Qualifications

• Bachelor’s degree (preferred)
• Experience with ACO/Risk Contracting (preferred)
• Experience with Value Based Contracting (preferred)
• Tribal health, Medicaid, and/or DNSP contracting experience (preferred)
• Located within the region (ID, MT, WA, WY, UT, OR, AK) (preferred)

Location

This is a remote/work-at-home role with the preferred candidate located within the region (ID, MT, WA, WY, UT, OR, AK).

Work at Home Requirements

• Self-provided internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps (wireless, wired cable, or DSL connection suggested)
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information

Travel

Occasional travel to Humana's offices for training or meetings may be required.

Pay

The starting base pay range for this full-time (40 hours per week) position is $94,900 - $130,500 per year. Pay may vary based on geographic location and individual qualifications, including skills, knowledge, experience, education, and certifications.

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

Benefits

Humana offers competitive benefits supporting whole-person well-being, including:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Paid time off (including company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance

About Us

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through Humana insurance services and CenterWell healthcare services, we make it easier for millions of people to achieve their best health.