Provider Contracting Executive - National Transplant Network

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Job Information
Humana
Provider Contracting Executive - National Transplant Network
in
Rogers
Arkansas
Description
The Provider Contracting Executive initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance for Humana's National Transplant Network. 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
5 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
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
Bachelor's degree
Understanding of the clinical aspects of transplants or complex care
Experience with ACO/Risk Contracting
Experience with Value Based Contracting
Additional Information
Work at Home/Remote Requirements 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
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.
Scheduled Weekly Hours
40

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