Provider Contracting Executive

🔥 2 minutes ago

🏈 Alabama, Mississippi, +1 more states – Remote

🏈 Alabama – Remote 🎸 Mississippi – Remote 🎸 Tennessee – Remote

💵 $94.9k - $130.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Executive

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Initiate, negotiate, and execute physician, hospital, and other provider contracts and agreements for Humana's Alabama Market • Serve as the primary point of contact with providers • Communicate contract terms, payment structures, and reimbursement rates to providers • Analyze the financial impact of contracts and terms • Maintain contracts and documentation within a tracking system • Identify and recruit providers based on network composition and needs • Advise executives on functional strategies and significant matters • Exercise independent judgment and make decisions on complex issues with minimal supervision • Travel to providers within the region up to 20% of the time

🎯 Requirements

• 5 or more years of progressive network management experience and network administration in a healthcare company • 2 or more years of project leadership experience • Extensive provider contracting skills, including contract negotiation, preparation and implementation, financial analysis, and rate proposal development • Must live within the region • Ability and willingness to travel to providers up to 20% of the time • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for home or hybrid home/office employees • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information • Bachelor's Degree preferred • Experience with ACO/Risk Contracting preferred • Experience with Value Based Contracting preferred

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Home or Hybrid Home/Office work arrangement • Occasional travel to Humana offices for training or meetings