Humana

About Humana

 

Job Category:

Market Strategy - Contracting

Country:

United States

Postal Code:

80015

Approximate Salary:

Not Specified

Position Type:

Full time

Director, Provider Contracting

Humana - Centennial

Posted: 07/4/2018

Description

Humana is looking for a Director of Provider Development who is self-motivated, and experienced leading teams of hospital and ancillary contracting. In addition, this Director will lead and manage the development of Humana’s overall provider relationships for Colorado and New Mexico, drive strategic initiatives within the provider network, and ensure that the alignment of departmental objectives is congruent with the overall business strategy.

Responsibilities

Responsibilities include:

  • Lead Provider Contracting for Colorado and New Mexico, Commercial, Medicare Advantage and Medicaid  
  • Initiate and maintain productive long-term relationships with provider representatives, subscribers, hospitals, account managers and internal sales teams
  • Provide effective operations management, ensuring that all contracts are within required guidelines and financial parameters, and maintain current provider data within payment systems
  • Apply economic and strategic planning models to all endeavors in your region in order to align business, process, and operational principles with area-specific goals

 Key Competencies

  • Business and Financial Acumen, Acts Strategically, Collaborates, Lead Positively, strong work ethic,  Operations , Human capital/management experience, understanding the technical aspects of contract operationalization

               

Role Essentials

  • Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital contracting
  • A minimum of 5 years’ progressive contracting experience
  • Solid leadership/management experience including supervisory and teambuilding
  • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
  • Proven contract preparation and negotiation skills,  with an in-depth knowledge of Medicare, Commercial and Medicaid  and other reimbursement methodologies

Role Desirables

  • Master’s Degree in Business Administration or Finance
  • Experience with ACO/Risk Contracting
  • Value based contracting experience
  • Revenue Cycle Management

Reporting Relationships

 This position reports to a Regional Vice President–Provider Experience, and lead a team of 9 associates.

Scheduled Weekly Hours

40

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