Humana
Base pay range: $94,900.00/yr - $130,500.00/yr
About the Role The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. They handle problems of diverse scope and complexity ranging from moderate to substantial.
The role involves communicating contract terms, payment structures, and reimbursement rates to providers, analyzing the financial impact of contracts, maintaining contracts and documentation within a tracking system, and assisting with identifying and recruiting providers based on network composition and needs. The Executive advises executives to develop functional strategies on matters of significance, exercises independent judgment and decision-making on complex issues, and works under minimal supervision.
Key Responsibilities
Initiate, negotiate, and execute provider contracts and agreements.
Communicate contract terms, payment structures, and reimbursement rates to providers.
Analyze the financial impact of contracts and terms.
Maintain contracts and documentation within a tracking system.
Assist with identifying and recruiting providers based on network composition and needs.
Advise executives on functional strategies for network management.
Exercise independent judgment and decision-making on complex issues.
Required Qualifications
Bachelor’s Degree.
8+ 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.
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.
Passion for contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Master’s Degree.
Managed Care Contracting experience.
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.
Work From Home / Internet Requirements
Minimum download speed of 25 Mbps and upload speed of 10 Mbps (wired or wireless).
Satellite, cellular, and microwave connections only if approved by leadership.
Employees in California, Illinois, Montana, or South Dakota will receive a bi‑weekly payment for internet expense.
Humana will provide telephone equipment to meet business requirements.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
SSN Information Applicants may be asked to provide their Social Security Number if it is not already on file.
Travel Occasional travel to Humana’s offices for training or meetings may be required.
Schedule 40 hours per week.
Pay Range $94,900 – $130,500 per year for starting base pay. The amount may vary based on geography and experience. Eligible for a bonus incentive plan.
Benefits Competitive benefits including medical, dental and vision coverage, 401(k), paid time off, disability, life insurance, and more. Humana encourages personal wellness and smart healthcare decisions for employees and families.
About Us Humana Inc. is committed to putting health first for teammates, customers and the company. Through Humana insurance services and CenterWell healthcare services, we help millions of people achieve their best health.
Equality & Diversity Humana is an equal‑opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. We also take affirmative action and base all employment decisions on valid job requirements.
Job Information
Seniority level: Mid‑Senior level
Employment type: Full‑time
Job function: Business Development and Sales
Industry: Insurance
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About the Role The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. They handle problems of diverse scope and complexity ranging from moderate to substantial.
The role involves communicating contract terms, payment structures, and reimbursement rates to providers, analyzing the financial impact of contracts, maintaining contracts and documentation within a tracking system, and assisting with identifying and recruiting providers based on network composition and needs. The Executive advises executives to develop functional strategies on matters of significance, exercises independent judgment and decision-making on complex issues, and works under minimal supervision.
Key Responsibilities
Initiate, negotiate, and execute provider contracts and agreements.
Communicate contract terms, payment structures, and reimbursement rates to providers.
Analyze the financial impact of contracts and terms.
Maintain contracts and documentation within a tracking system.
Assist with identifying and recruiting providers based on network composition and needs.
Advise executives on functional strategies for network management.
Exercise independent judgment and decision-making on complex issues.
Required Qualifications
Bachelor’s Degree.
8+ 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.
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.
Passion for contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Master’s Degree.
Managed Care Contracting experience.
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.
Work From Home / Internet Requirements
Minimum download speed of 25 Mbps and upload speed of 10 Mbps (wired or wireless).
Satellite, cellular, and microwave connections only if approved by leadership.
Employees in California, Illinois, Montana, or South Dakota will receive a bi‑weekly payment for internet expense.
Humana will provide telephone equipment to meet business requirements.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
SSN Information Applicants may be asked to provide their Social Security Number if it is not already on file.
Travel Occasional travel to Humana’s offices for training or meetings may be required.
Schedule 40 hours per week.
Pay Range $94,900 – $130,500 per year for starting base pay. The amount may vary based on geography and experience. Eligible for a bonus incentive plan.
Benefits Competitive benefits including medical, dental and vision coverage, 401(k), paid time off, disability, life insurance, and more. Humana encourages personal wellness and smart healthcare decisions for employees and families.
About Us Humana Inc. is committed to putting health first for teammates, customers and the company. Through Humana insurance services and CenterWell healthcare services, we help millions of people achieve their best health.
Equality & Diversity Humana is an equal‑opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. We also take affirmative action and base all employment decisions on valid job requirements.
Job Information
Seniority level: Mid‑Senior level
Employment type: Full‑time
Job function: Business Development and Sales
Industry: Insurance
#J-18808-Ljbffr