Provider Contracting Executive
About the position
The Provider Contracting Executive at Humana plays a crucial role in the healthcare network by initiating, negotiating, and executing contracts with physicians, hospitals, and other providers. This position is essential for ensuring that the organization maintains a robust network of healthcare providers to deliver quality services to its members. The executive will work on a variety of problems that range from moderate to substantial complexity, requiring a deep understanding of the healthcare landscape and the ability to navigate various challenges effectively. In this role, the Provider Contracting Executive will communicate contract terms, payment structures, and reimbursement rates to providers specifically within the Louisiana Market. A significant part of the job involves analyzing the financial impact of contracts and their terms, ensuring that the organization remains financially viable while providing necessary services. The executive will also maintain contracts and documentation within a tracking system, which is vital for compliance and operational efficiency. Additionally, the role may involve assisting in identifying and recruiting providers based on the network's composition and needs, thereby contributing to the overall growth and sustainability of the healthcare network. The Provider Contracting Executive will advise executives on developing functional strategies that are often segment-specific, addressing matters of significance that impact the organization. This position requires independent judgment and decision-making on complex issues related to job duties and tasks, and it operates under minimal supervision. The ability to analyze variable factors and determine the best course of action is essential for success in this role. Overall, this position is integral to Humana's mission of putting health first and ensuring that the organization can effectively serve its members.
Responsibilities
Initiate, negotiate, and execute contracts with physicians, hospitals, and other providers.
,
Communicate contract terms, payment structures, and reimbursement rates to providers in the Louisiana Market.
,
Analyze the financial impact of contracts and their terms.
,
Maintain contracts and documentation within a tracking system.
,
Assist in identifying and recruiting providers based on network composition and needs.
,
Advise executives on developing functional strategies related to provider contracting.
,
Exercise independent judgment and decision-making on complex issues regarding job duties and related tasks.
Requirements
5 or more years of progressive network management experience in a healthcare company.
,
2 or more years of project leadership experience.
,
Extensive provider contracting skills, including contract preparation, negotiation, implementation, financial analysis, and rate proposal development.
,
Excellent written and verbal communication skills with experience presenting to varied audiences.
,
Ability to manage multiple priorities in a fast-paced environment.
,
Knowledge of Microsoft Office applications.
,
Ability and willingness to travel within the region, on occasion.
Nice-to-haves
Bachelor's degree.
,
Hospital contracting experience.
,
Experience with ACO/Risk Contracting.
,
Experience with Value Based Contracting.
Benefits
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
Apply Now
The Provider Contracting Executive at Humana plays a crucial role in the healthcare network by initiating, negotiating, and executing contracts with physicians, hospitals, and other providers. This position is essential for ensuring that the organization maintains a robust network of healthcare providers to deliver quality services to its members. The executive will work on a variety of problems that range from moderate to substantial complexity, requiring a deep understanding of the healthcare landscape and the ability to navigate various challenges effectively. In this role, the Provider Contracting Executive will communicate contract terms, payment structures, and reimbursement rates to providers specifically within the Louisiana Market. A significant part of the job involves analyzing the financial impact of contracts and their terms, ensuring that the organization remains financially viable while providing necessary services. The executive will also maintain contracts and documentation within a tracking system, which is vital for compliance and operational efficiency. Additionally, the role may involve assisting in identifying and recruiting providers based on the network's composition and needs, thereby contributing to the overall growth and sustainability of the healthcare network. The Provider Contracting Executive will advise executives on developing functional strategies that are often segment-specific, addressing matters of significance that impact the organization. This position requires independent judgment and decision-making on complex issues related to job duties and tasks, and it operates under minimal supervision. The ability to analyze variable factors and determine the best course of action is essential for success in this role. Overall, this position is integral to Humana's mission of putting health first and ensuring that the organization can effectively serve its members.
Responsibilities
Initiate, negotiate, and execute contracts with physicians, hospitals, and other providers.
,
Communicate contract terms, payment structures, and reimbursement rates to providers in the Louisiana Market.
,
Analyze the financial impact of contracts and their terms.
,
Maintain contracts and documentation within a tracking system.
,
Assist in identifying and recruiting providers based on network composition and needs.
,
Advise executives on developing functional strategies related to provider contracting.
,
Exercise independent judgment and decision-making on complex issues regarding job duties and related tasks.
Requirements
5 or more years of progressive network management experience in a healthcare company.
,
2 or more years of project leadership experience.
,
Extensive provider contracting skills, including contract preparation, negotiation, implementation, financial analysis, and rate proposal development.
,
Excellent written and verbal communication skills with experience presenting to varied audiences.
,
Ability to manage multiple priorities in a fast-paced environment.
,
Knowledge of Microsoft Office applications.
,
Ability and willingness to travel within the region, on occasion.
Nice-to-haves
Bachelor's degree.
,
Hospital contracting experience.
,
Experience with ACO/Risk Contracting.
,
Experience with Value Based Contracting.
Benefits
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
Apply Now