Provider Contracting Professional

Humana Inc; Washington; Hybrid; USD 65,000 - 89,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement plan

Paid time off

Holidays

Job summary

Humana Inc. seeks a Provider Contracting Professional to support the West Region in negotiating and maintaining provider agreements and to assist with contract management and analytics.

The role collaborates with market engagement, leadership, and legal teams to ensure accurate documentation and compliant processes. Responsibilities include drafting and reviewing contracts, communicating terms and rates to IPA/ACO groups, conducting basic financial analyses, and maintaining files in the tracking

Qualifications

• 2+ years' experience in provider contracting, network management, or related healthcare field.
• Knowledge of managed care or value-based contracting.
• Understand contract terms and basic financial impact.
• Experience with ACO or IPA networks (preferred).
• Experience with provider relations (preferred).
• Familiarity with contract tracking systems (preferred).
• Experience with Value Based Contracting (preferred).

Responsibilities

• Support the contracting team in drafting, reviewing, and processing provider contracts and amendments.
• Collaborate with market engagement, leadership, and legal teams to facilitate contract execution and resolve basic contract term revisions.
• Assist in communicating contract terms, payment structures, and reimbursement rates to IPA and ACO provider groups under senior guidance.
• Conduct initial financial analyses of contracts and terms; prepare summaries for senior review.
• Maintain contract files and documentation within the organization's tracking system, ensuring accuracy and compliance.
• Assist in identifying and reaching out to potential providers for network development based on current needs.
• Prepare reports and updates for contracting initiatives as requested.
• Manage assigned priorities and deadlines, escalating complex issues to senior team members.

Skills

Provider contracting experience

Knowledge of managed care

Understanding financial impact of term

Job description

Become a part of our caring community The Provider Contracting Professional supports the West Region in the negotiation, analysis, and maintenance of physician and other provider agreements for an organization delivering healthcare to the senior population. You will assist with contract management activities, provides analytical support, and ensure accurate documentation within established processes and guidelines. You will report to a Director, Provider Contracting.

Job Responsibilities:

• Support the contracting team in drafting, reviewing, and processing provider contracts and amendments
• Collaborate with market engagement, leadership, and legal teams to facilitate contract execution and resolve basic contract term revisions
• Assist in communicating contract terms, payment structures, and reimbursement rates to IPA and ACO provider groups under the guidance of senior staff
• Conduct initial financial analyses of contracts and terms; prepare summaries for senior review
• Maintain contract files and documentation within the organization's tracking system, ensuring accuracy and compliance
• Assist in identifying and reaching out to potential providers for network development based on current needs and network composition
• Prepare reports and updates for contracting initiatives as requested
• Manage assigned priorities and deadlines, escalating complex issues to senior team members
• Use your skills to make an impact

Required Qualifications

• 2+ years' experience in provider contracting, network management, or a related healthcare field
• Knowledge of managed care or value-based contracting
• Understand contract terms and basic financial impact

Preferred Qualifications

• Experience supporting ACO or IPA provider networks
• Experience with provider relations
• Familiarity with contract tracking or management systems
• Experience with Value Based Contracting

Additional Information

Work at Home Requirements:

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$65,000 - $88,600 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need to them when needed. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.