Humana Provider Contracting Executive in Greenville, South Carolina
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.
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. May assist with identifying and recruiting 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.
5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company
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
Reliable transportation with valid driver's license and the ability and willingness to travel throughout the State of South Carolina up to 25% of the time
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Experience with Medicare, Commercial, and Medicaid Contracting
This position is considered "work at home", however, you must live in the South Carolina area as this role will require daily travel within the region.
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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