Provider Contracting Executive

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

5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company

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

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Master's Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Additional Information

Ideal candidates should live within GA or Upstate SC (Greenville or Spartanburg), Northern FL, Charlotte NC or TN.

AttachmentsAttachments

Scheduled Weekly Hours

40

Company info

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