Humana

About Humana

 

Job Category:

Market Strategy - Operations

Country:

United States

Postal Code:

10001

Approximate Salary:

Not Specified

Position Type:

Full Time

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Provider Development Network Operations Executive

Humana - New York, New York

Posted: 10/20/2018

Description

As a Provider Development Network Operations Executive you will prioritize network needs both quantitatively and qualitatively, coordinating internal and external projects, and developing tracking mechanisms for key metrics of contract performance. The Provider Development Network Operations Executive would also work with the contracting team to manage the contract negotiations calendar, develop analytical tools to evaluate contract performance, and coordinate efforts to ensure Humana is meeting network adequacy requirements with the government business. The Provider Development Network Operations Executive will also support the contracting team to negotiate contracts that are favorable to Humana’s business and be involved in management of the submittal of networks to meet requirements.

• Create trend analyses and summaries for decision-making purposes.
• Develop and maintain analytical tools to summarize contract performance to the original agreement.
• Lead the development and implementation of cross-functional projects to support corporate and regional contracting efforts
• Interface with market leaders to align contracting needs and business efforts.
• Work with the Corporate Network/Provider team as a liaison between the Region and Corporate teams.
• Support the targets and priorities set by leadership to meet national and market-specific network needs by managing network administration of contracts.

Responsibilities

As a Provider Development Network Operations Executive you will prioritize network needs both quantitatively and qualitatively, coordinating internal and external projects, and developing tracking mechanisms for key metrics of contract performance. The Provider Development Network Operations Executive would also work with the contracting team to manage the contract negotiations calendar, develop analytical tools to evaluate contract performance, and coordinate efforts to ensure Humana is meeting network adequacy requirements with the government business. The Provider Development Network Operations Executive will also support the contracting team to negotiate contracts that are favorable to Humana’s business and be involved in management of the submittal of networks to meet requirements.

  • Create trend analyses and summaries for decision-making purposes.
  • Develop and maintain analytical tools to summarize contract performance to the original agreement.
  • Lead the development and implementation of cross-functional projects to support corporate and regional contracting efforts
  • Interface with market leaders to align contracting needs and business efforts.
  • Work with the Corporate Network/Provider team as a liaison between the Region and Corporate teams.
  • Support the targets and priorities set by leadership to meet national and market-specific network needs by managing network administration of contracts.

               

Required Qualifications

  • Bachelor's degree
  • Experience with analyzing, understanding and communicating financial trends
  • 2+ years of project leadership experience
  • Knowledge of Provider Contracting and Network Development

  • Regulatory knowledge

  • Strong communication consulting and negotiation skills

  • Ability to set and prioritize short, mid and long term objectives

  • Proficient with Microsoft Word, Excel and PowerPoint

Preferred Qualifications

  • Graduate degree preferred
  • Knowledge of Humana’s internal policies, procedures and systems
  • Contracting Experience
  • Experience with Value Based Care
  • Management Experience

Additional Information

Scheduled Weekly Hours

40

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