Humana is seeking a Senior Provider Contracting Professional to serve as a primary point of contact for our provider partners. You will drive the negotiation and execution of contracts with physicians, hospitals, and other healthcare organizations, aligning agreements with Humana’s strategic goals.
What You'll Do
- Negotiate and manage complex provider contracts.
- Build and maintain relationships with healthcare providers.
- Analyze provider performance and financial impact.
- Collaborate with internal teams to ensure contract compliance.
- Monitor and resolve provider issues related to contracts.
- Identify opportunities for network improvement and cost savings.
- Mentor and support junior contracting staff.
- Report contract status and metrics to leadership.
- Clearly communicate contract terms, payment structures, and reimbursement rates to providers.
- Maintain accurate contract documentation within a tracking system.
- Assist with identifying and recruiting providers to support network needs.
What We're Looking For
- Bachelor's degree or equivalent work experience
- 4+ years of progressive network management/operations experience including contracting and/or network administration/operations in a healthcare company
- Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers
- Excellent written and verbal communication skills
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency in MS Office applications
Nice to Have
- Master's Degree
- Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting especially in a delegated environment
Technical Stack
- MS Office applications
Team & Environment
Influences departmental strategy, independently makes decisions on complex project components, and exercises considerable latitude in determining objectives and approaches to assignments.
Benefits & Compensation
- Compensation: $78,400 - $107,800 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
- Bonus incentive plan based upon company and/or individual performance
Work Mode
This is a remote position open to candidates residing in NV, HI, NM, AZ, CO, or CA.
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.
