Remote Hospital Contracting Lead – Value-Based Negotiations

Humana Inc; Lansing (MI); Remote; USD 78,000 - 108,000; Full time

Job summary

Humana Inc. is seeking a Senior Hospital Contracting Strategist/Negotiator to initiate, negotiate and execute physician, hospital and provider contracts for a health insurance organization. You will report to the Director, Provider Contracting.

The role requires extensive hospital contracting expertise, Medicare/Medicaid experience, and strong financial analysis skills. Remote work with some travel supports a dynamic healthcare network strategy.

Qualifications

• Bachelor's degree required.
• 5+ years of Hospital negotiation experience in Medicare.
• Leading negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value-based agreements.
• 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.
• Experience negotiating managed care contracts with hospital systems including post-acute, ancillary providers and physicians.
• Analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers.
• Understand and interpret hospital contract language.
• Proficient in Microsoft Office: Word, Excel and PowerPoint.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value-based agreements.
• Collaborate with Finance, Legal, Network Management, Claims and Operations to ensure contracts are financially sound.
• 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.
• Aid in identifying and recruiting providers based on network needs.

Skills

Hospital negotiating experience

Negotiations leadership

Network management experience

Medicare/Medicaid contracting

Financial analysis

Contract language interpretation

Communication of contract terms

Education

Bachelor's degree

Master's degree (preferred)

Tools

Microsoft Office (Word, Excel, PowerPoint)

Job description

Humana Inc. is seeking a Senior Hospital Contracting Strategist/Negotiator to initiate, negotiate and execute physician, hospital and provider contracts for a health insurance organization. You will report to the Director, Provider Contracting.

The role requires extensive hospital contracting expertise, Medicare/Medicaid experience, and strong financial analysis skills. Remote work with some travel supports a dynamic healthcare network strategy.