Provider Contracting Executive
Humana

Malta, Montana

Posted in Insurance
5 days ago


Job Info


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 is responsible for value based contracting for complex provider systems and negotiates incentive based compensation to motivate provider performance. This position is also responsible for a geographic network, insuring the highest quality of providers available for our members and engaged providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. 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

  • 4 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
  • 8+ years of healthcare industry 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
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Willing to travel within the local region as required
Preferred Qualifications
  • Bachelor's Degree
  • Experience with ACO/Risk Contracting
  • Experience with Value Based Contracting
Additional Information

This person will be remote/work at home, however, preference is given to candidates that are located in the Pacific, Central or Mountain Time Zones

Scheduled Weekly Hours

40



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