Remote Hospital Contracting Lead - Value-Based Negotiations

CarePlus Health Plans; Georgia; On-site; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

CarePlus Health Plans in Georgia seeks a Senior Hospital Contracting Strategist to initiate, negotiate and execute hospital and provider contracts across the network. You will lead complex negotiations ensuring financial viability and strategic alignment with care delivery goals.

You will collaborate with Legal, Finance and Network Management, analyze reimbursement methods, and communicate terms to providers while supporting Medicare Advantage and Medicaid contracts within Humana’s CarePlus

Qualifications

• Bachelor's degree required; Master's preferred.
• 5+ years of hospital negotiation experience in Medicare.
• Progressive network management experience including hospital contracting.
• Experience negotiating managed care contracts with hospital systems.
• Ability to analyze and communicate financial impact of contract terms.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value-based agreements.
• Analyze financial impact of contracts and terms; ensure contracts are financially sound.
• Maintain contracts and documentation within a tracking system.
• Collaborate with Finance, Legal, Network Management, Claims, and Operations to support operational execution.

Skills

Hospital contract negotiations

Financial analysis

Value-based contracting

Provider relationship management

Leadership

Education

Bachelor's degree

Master's degree

Tools

Microsoft Office

Job description

CarePlus Health Plans in Georgia seeks a Senior Hospital Contracting Strategist to initiate, negotiate and execute hospital and provider contracts across the network. You will lead complex negotiations ensuring financial viability and strategic alignment with care delivery goals.

You will collaborate with Legal, Finance and Network Management, analyze reimbursement methods, and communicate terms to providers while supporting Medicare Advantage and Medicaid contracts within Humana’s CarePlus