• Job Description

  Req#: R-342215

  Become a part of our caring community and help us put health first
  

  The Provider Contracting Executive will be building and servicing hospital networks from the ground up with little direction. In this role, you will initiate, negotiate, and execute physician, ancillary, and/or other provider contracts and agreements for Virginia Medicare and Medicaid providers. The Provider Contracting Executive's work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

  • The Provider Contracting Executive negotiates and communicates contract terms, payment structures, and reimbursement rates to providers that are aligned with Humana's financial strategies
  • Maintains contracts and documentation within a tracking system
  • Identifies and recruits 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.

  
  Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

  • Health benefits effective day 1
  • Paid time off, holidays, volunteer time and jury duty pay
  • Recognition pay
  • 401(k) retirement savings plan with employer match
  • Tuition assistance
  • Scholarships for eligible dependents
  • Parental and caregiver leave
  • Employee charity matching program
  • Network Resource Groups (NRGs)
  • Career development opportunities

  
  Use your skills to make an impact
  

  Required Qualifications

  • 5 or more years of progressive network management experience working with hospitals, facilities and other large provider practices on recruitment and service activities

  • Experienced in negotiating or servicing managed care contracts with large physician groups, ancillary providers and hospitals

  • Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.

  • Experience with Medicaid Contracting

  • Experience with ACO/Risk Contracting

  • Excellent written and verbal communication skills

  • Proficiency in MS Office applications

  Preferred Qualifications

  • Advanced degree (Bachelor's, Master's, JD)

  • Experience with Value Based Contracting

  Additional Information

  This position is considered "remote/work at home", however, the preferred candidate will live within driving distance to providers within the State of Virginia.

  • 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

  Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of COVID-19 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.

  #LI-Remote

  #LI-JR1

  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.

  
  

  $93,000 - $128,000 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.

  
  About us
  

  Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

  
  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 because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

• About the company

  Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs

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