Provider Contracting Executive

Become a part of our caring community The Provider Contracting Executive executes physician, hospital, and other provider contracts and agreements for organizations that provide health insurance. The Provider Contracting Executive will support the Nevada and Hawaii market and works on problems of diverse scope and complexity ranging from moderate to substantial, reporting directly to the Provider Contracting Director. Duties and Responsibilities You will prepare and communicate contract terms, payment structures, and reimbursement rates to providers. Analyze the financial impact of contracts and contract terms. Maintain contracts and related documentation within a tracking system. Identify and recruit providers based on network composition and needs. Advise executives on developing functional strategies (often segment-specific) for significant matters. Required Qualifications At least 5+ years of health care or managed care experience with focus in Provider Contracting, Network Management or Provider Relations. 2+ years of demonstrated project management experience and partnering with senior leadership on strategic initiatives. 2+ years of value-based contracting. 2+ years of facility and ancillary contracting. Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies. Experience managing various projects simultaneously. Ability to travel as needed. Must work Pacific Standard Time (PST). Preferred Qualifications Bachelor's degree in business, healthcare administration, finance, or a related field. Experience and comfort with contract management systems. Knowledge of Medicare Stars and HEDIS measures. Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance. Comprehensive knowledge of Medicare policies, processes and procedures. Resides in AZ, CA, CO, HI, NM, NV, OR, or WA. Work-At-Home Requirements Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite, cellular and microwave connection can be used only if approved by leadership. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $94,900 - $130,500 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our #J-18808-Ljbffr