Director, Provider Contracting — Remote (Northeast)

Humana; Delaware; Remote; USD 139,000 - 191,000; Full time

Benefits offered by this job

Bonus incentive plan

Work from home

Job summary

Humana is seeking a Director, Provider Contracting to initiate, negotiate, and execute physician and hospital provider contracts. The role requires deep understanding of Medicare contracting, value-based arrangements, and financial impact assessment.

The position is remote with a Northeast Region residency requirement and may involve travel for training or meetings. It offers a strong bonus plan and a focus on strategic program implementations within Humana's network.

Qualifications

• Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital and value-based contracting
• A minimum of 5 years contracting experience to include hospital and value-based contracting
• Experience leading people or projects
• 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 contracting including Value Based/ Incentive contracting experience
• Must live within the Northeast Region (MD, DC, DE, PA, NJ, NY, CT, MA, ME, NH, VT, RI)

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements.
• Communicates contract terms, payment structures, and reimbursement rates to providers.
• Analyzes financial impact of contracts and terms.
• Maintains contracts and documentation within a tracking system.
• May assist with identifying and recruiting providers based on network composition and needs.
• Implements strategic plans, drives goals and objectives, and improves performance.

Skills

Contract negotiation

Financial acumen

Leadership experience

Medicare contracting knowledge

Remote work readiness

Education

Bachelor's degree in Business/Finance

Master's degree (preferred)

Tools

Contract management systems

Job description

Humana is seeking a Director, Provider Contracting to initiate, negotiate, and execute physician and hospital provider contracts. The role requires deep understanding of Medicare contracting, value-based arrangements, and financial impact assessment.

The position is remote with a Northeast Region residency requirement and may involve travel for training or meetings. It offers a strong bonus plan and a focus on strategic program implementations within Humana's network.