Provider Contracting Executive - WAH CA

Profile

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 or relevant 5 years of experience

5 or more years of progressive network management experience including Hospital Contracting and Network Administration in a Healthcare company

Familiarized with the California Provider landscape

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

Preferred Qualifications

Experience with both Fee for Service and Risk Contracting

Knowledge of Value Based Contracting

Experience with the California provider landscape

Additional information

Schedule Monday to Friday from 8 am to 5 pm. Limited Overtime

Work Location (Address): Work At Home, but associate may be asked to come to a Humana office location for meetings from time to time.

Travel: 15-20%

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com