Provider Contracting Executive

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

The Contracting Executive will be responsible for setting VBC/APM contracting strategies within an assigned geographical region and executing upon said strategy. 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.

55% 1. The Contracting Executive role will maintain responsibility for developing contracting methodologies and foster relationships with large hospital systems. Maintains metrics and health quality based goals to meet and exceed for providers to gain additional payments. Cross team collaboration will be essential within HGB between, the Contracting Executive role, Actuary, Market Field Leadership, and Executive Council in order to ensure goals are met.

Will also influence the field in terms of which systems to partner with, provide sound contracting strategy as well as contract template development, which will require expertise, creativity in their approach, keen sense of negotiating, and a steadfast, pragmatic approach in order to ensure we improve the care of the TRICARE beneficiaries.

25% 2. Works with senior executives on the development of functional strategies (often segment specific) and provides recommendations to senior executives on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks and works under nominal supervision. Employs strategic thinking analysis of multiple and variable factors determining the best course of action. Utilizes considerable latitude in determining task objectives and approaches to completing assignments to meet goals and set deadlines.

10% 3. Advanced subject matter expert, highly competent able to work at very high levels in multiple knowledge and functional areas across multiple departments.

10% 4. 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 analysis and recruitment of providers based on network deficiencies, composition and needs.

• Our Department of Defense Contract requires U.S. citizenship for this position
• Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
• HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
• Bachelor's Degree
• 5 years of experience with Value Based Contracting
• 3 years of experience with provider contracting skills including contract preparation and implementation, strong financial acumen with proficiency in analysis of rate proposal development
• Experience presenting to varied audiences

• 2 years of project management experience
• Master's Degree
• Experience with military contracting

• 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
• Associates 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 associates 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

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

40

The compensation range below reflects a good faith estimate of starting base pay for full time (40…