CenterWell Pharmacy is seeking a Director, Provider Contracting to initiate, negotiate, and execute physician, hospital, and other provider contracts for the State of Ohio. This role leads the Contracting Team for the Midwest Region and plays a key part in connecting our organizational capabilities across the segment.
What You'll Do
- Initiate, negotiate, and execute physician, hospital, and/or other provider contracts and agreements for the State of Ohio.
- Communicate contract terms, payment structures, and reimbursement rates to providers.
- Analyze financial impact of contracts and terms.
- Maintain contracts and documentation within a tracking system.
- Assist with identifying and recruiting providers based on network composition and needs.
- Lead the Contracting Team for the Midwest Region.
- Implement strategic plans, drive goals and objectives, and improve performance.
- Provide input into functions strategy.
What We're Looking For
- 5+ years of provider contracting experience, including contract preparation, negotiation, implementation, financial analysis, and rate proposal development.
- Proven leadership experience, including teambuilding.
- In-depth knowledge of Medicare and other reimbursement methodologies.
- Strong financial acumen with proficiency in analyzing and interpreting financial trends in provider contracting.
- Must live within the region (OH, IN, KY, WV, MI).
Nice to Have
- Bachelor's Degree.
- Experience with ACO/Risk Contracting.
- Value based contracting experience.
Team & Environment
You will lead the Contracting Team for the Midwest Region.
Benefits & Compensation
- Compensation: $138,900 - $191,000 per year.
- Medical, dental and vision benefits.
- 401(k) retirement savings plan.
- Time off, including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave.
- Short-term and long-term disability.
- Life insurance.
Work Mode
This is a remote position open to candidates in OH, IN, KY, WV, MI.
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.
