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Humana Provider Contracting Executive in Overland Park, Kansas

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 is familiar with value based contracting for complex provider systems and negotiates incentive based compensation to motivate provider performance. This position is also responsible for a geographic network, insuring the highest quality of providers available for our members and engaged providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. 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 4+ years of progressive network management experience including hospital contracting and network administration in a healthcare company

  • 5+ years of healthcare industry 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

  • Willing to travel within the local region approximately 25% of the time

  • Our company requires vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications

  • Master's Degree

  • Experience with ACO/Risk Contracting

  • Experience with Commercial, Medicaid & Medicare

  • Experience with Value Based Contracting

Additional Information

Work-At-Home Requirements

  • WAH 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 and Wireless Internet service is NOT allowed for this role.

  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

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