Humana

About Humana

 

Job Category:

Market Strategy - Contracting

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

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Associate Director - Provider Contracting

Humana - Work At Home, California

Posted: 10/20/2018

Description

The Associate Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Associate Director, Provider Contracting requires a solid understanding of how organization capabilities interrelate across department(s).

Responsibilities

The Associate Director, Provider Contracting leads complex negotiations regarding contract terms, various payment structures, and reimbursement rates to providers.

Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. Will assist with development of market strategy of identifying and recruiting providers based on network composition and needs. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.

               

Required Qualifications

  • Bachelor's Degree or equivalent
  • 8-10+ years of progressive contracting experience for a national health plan including hospital contracting and VBC contracting
  • 4+ years of management experience including supervising and team building
  • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
  • Proven contract preparation skills, with an in-depth knowledge of Medicare, Commercial and other reimbursement methodologies
  • 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

 Preferred Qualifications

  • Master's Degree
  • Experience with ACO/Risk Contracting
  • Value based contracting experience

Scheduled Weekly Hours

40

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