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Provider Contracting Executive

Humana
Work at Home - Nebraska, United States, United StatesRemotefull_timeVerifiedPosted 7 Apr 2025
💰 $130,500/yr($94,900/yr$130,500/yr)

About the role

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

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.


Use your skills to make an impact
 

Required Qualifications

  • 8 or more years of progressive network management experience including hospital contracting and network administration 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

  • Demonstrated ability to articulate ideas effectively in both written and oral forms

  • 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

Preferred Qualifications

  • Bachelor’s Degree

  • Experience with ACO/Risk Contracting

  • Experience with Value Based Contracting

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Benefits Information:

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

Work At Home / Internet Information:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

  • Satellite, cellular and microwave connection can be used only if approved by leadership

  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional trave

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Company

Humana

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