Hospital Contracting Executive
Humana

Job Info

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Description

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. 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. Identifies and recruit 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
• 6 or more years of progressive network management experience including negotiating hospital and provider contracts in 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
• 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 be willing and able to travel to provider offices within the region up to 20% of the time

Preferred Qualifications

• Master's Degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Additional Information

The ideal candidate will be based in the Dallas/Fort Worth area, however, will consider other locations within the State, for a highly qualified candidate.

For "remote/work at home" associates, Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

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