Role : Contracting Manager
Assignment : North Central Region
Location : Regional Market Office (Chicago, IL; Minneapolis, MN; or Milwaukee, WI)
We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our providers, consumers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our providers, members, employers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.
In alignment with this focus, we are launching a search focused on identifying three (3) operations managers who will be responsible for supporting Humana’s provider operations for value-based contracting for our North Central market, an 8 state region including IL, WI, MN, IA, NE, etc., covering over 400k total lives including 250,000 Medicare Advantage lives, 150,000 Commercial Group lives, and 10,000 Dual Demonstration lives.
The Contracting Manager is responsible to lead a team with the focus of providing contracting, operations and service support to our valued-based providers, business partners, and other internal and external stakeholders to meet our Perfect Service and Provider Experience mission across all products – Commercial, Medicare, Medicaid, and Dual Eligible.
Assignment Capsule The Contracting Manager will lead and manage a portion of the development of Humana’s overall provider relationships within a geographic market. Drive strategic initiatives within the provider network and ensure that the alignment of departmental objectives is congruent with the overall business strategy. * Lead on key provider contracting initiatives and network operations accountabilities within a market
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 o within required legal and compliance guidelines and financial parameters
o administered, and serviced within required timing guidelines, operational, and data accuracy parameters
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
Lead teams of direct or indirect reports on key initiatives and projects to achieve assigned goals Key Competencies
Business and Financial Acumen, Acts Strategically, Collaborates, Lead Positively, Operations a plus, Human capital/management experience, understanding the technical aspects of contract operationalization
Successful candidates will likely have the following:
At least 3 - 5 years’ of provider contracting experience including hospital contracting experience, value based contracting experience, and ACO/Risk Contracting experience
Network operations experience
Effective leadership/management experience including supervisory and teambuilding at a national health plan
Strong financial acumen with proficiency in analyzing and interpreting financial trends preferably in the provider contracting arena
Strong operational acumen with proficiency in creating and using data and metrics to drive improvements in team and individual performance
Knowledge and understanding of Medicare, Commercial, Medicaid business including reimbursement methodologies and processes
Demonstrated contract preparation and executive level presentation skills
10% or more travel
Operations experience related to data integrity of a provider network
Master’s Degree in Business Administration or Finance
Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital contracting
Proven contract preparation skills, with an in-depth knowledge of Medicare, Commercial, Medicaid, and other reimbursement methodologies and processes
Bachelor’s Degree or greater in Business, Finance or a related field
Title: Contracting Manager
Other Locations: US-Illinois-Chicago, US-WI-Waukesha
Requisition ID: 179181
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.