Provider Contracting Executive - Hospital Systems

Profile

Job Information

Humana

Provider Contracting Executive - Hospital Systems

in

Tampa

Florida

Description

The Provider Contracting Executive - Hospital Systems, 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 and leadership teams of large hospital systems. 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. Responsible for network trends, provider performance and engagement. 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

6 or more years of progressive network management experience to include contracting with hospital systems for a healthcare company

2 or more years of project leadership experience

Extensive provider contracting skills, including contract preparation and implementation, financial analysis and rate proposal development

Experience managing and reporting provider performance metrics

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

Must have a valid driver's license with reliable transportation and the ability to travel within the region up to 20% of the time

Preferred Qualifications

Master's Degree

Experience with ACO/Risk Contracting

Hospital contracting experience

Value Based contracting experience

Ancillary provider contracting

Additional Information

This role will be remote/work at home, however, you must be within the Florida Market

Scheduled Weekly Hours

40

Company info

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