Humana Looking For Provider Contracting Executive – Remote OK at Tulsa, OK Full Time

The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts. 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. 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.

Required Qualifications

Bachelor’s degree

6 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

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

This position is for individuals residing in OK and requires up to 25% travel throughout the state of OK as well as occasionally to Overland Park KS for departmental meetings

Preferred Qualifications

Master’s Degree

Experience with ACO/Risk Contracting

Experience with Value Based Contracting

Additional Information

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

• Provide proof of full vaccination or commit to testing protocols OR
• Provide proof of applicable exemption including any required supporting documentation

Medical, religious, state and remote-only work exemptions are available.

This position is considered “remote/work at home”, however, you must live in either Nebraska or Iowa as you will be required to travel to providers within this region up to 20% of the time. Occasional travel to Humana’s office in Kansas City.

Work at Home/Remote 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 25×10 (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