Provider Contracting Executive

Humana Inc. Dublin , OH 43016

Posted 4 weeks ago

Description

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.

Responsibilities

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.

Required Qualifications

  • Bachelor's degree

  • 6+ 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 preparation and implementation, financial analysis and rate proposal development

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

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

  • Knowledge of Microsoft Office applications

  • Valid driver's license with reliable transportation and the ability to travel within the region up to 30% of the time

Preferred Qualifications

  • Master's Degree

  • Experience with ACO/Risk Contracting

  • Experience with Value Based Contracting

Additional Information

This role can be based in any of the following Humana offices: Cleveland, Springdale, Dublin, OH or Indianapolis, IN

Scheduled Weekly Hours
40


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Provider Contracting Executive

Humana Inc.