Remote Hospital Contracting Strategist - Value-Based

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

Benefits offered by this job

Bonus incentive plan

Remote position

Job summary

CarePlus Health Plans, a Humana subsidiary serving Medicare beneficiaries, seeks a Senior Hospital Contracting Strategist/Senior Provider Contracting Professional to initiate, negotiate, and execute hospital and other provider contracts. You will report to the Director, Provider Contracting and collaborate across Finance, Legal, Network Management, Claims, and Operations.

The role requires deep Medicare Advantage/Medicaid experience, strong financial analysis, and proven negotiation leadership.

Qualifications

• Bachelor's degree required; Master's highly preferred.
• 5+ years of hospital negotiation experience in Medicare and managed care.
• Experience leading hospital and health system contract negotiations.
• Strong ability to analyze financial impact of contract terms.

Responsibilities

• Lead negotiations for hospital and health system agreements including reimbursement and value-based terms.
• Demonstrated expertise in hospital contracting, reimbursement methodologies, and financial analysis.
• Negotiate with Medicare Advantage, Medicaid, and value-based contracting entities.
• Evaluate reimbursement methods such as DRG, PD, and case rates.
• Collaborate with Finance, Legal, Network Management, Claims, and Operations to ensure contracts are sound.
• Communicate contract terms and payment structures to providers.
• Maintain contracts and track documentation; assist in recruiting providers.

Skills

Negotiation

Leadership

Financial analysis

Education

Bachelor's degree

Master's Degree

Tools

Microsoft Word

Excel

PowerPoint

Job description

CarePlus Health Plans, a Humana subsidiary serving Medicare beneficiaries, seeks a Senior Hospital Contracting Strategist/Senior Provider Contracting Professional to initiate, negotiate, and execute hospital and other provider contracts. You will report to the Director, Provider Contracting and collaborate across Finance, Legal, Network Management, Claims, and Operations.

The role requires deep Medicare Advantage/Medicaid experience, strong financial analysis, and proven negotiation leadership.