Remote Hospital Contracting Strategist | Value-Based Pay Expert

Humana Inc; Santa Fe (NM); 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 hospital and provider contracts, reporting to the Director, Provider Contracting.

This role leads negotiations, analyzes financial impact, and coordinates with Finance, Legal, and Network Management to ensure contracts are financially sound. The position offers a remote role with travel as needed, pays a base range reflecting market rates, and eligibility for a bonus incentive plan.

Qualifications

• Bachelor's degree required.
• 5+ years hospital negotiation experience in Medicare.
• Experience leading hospital and health system contract negotiations.
• 5+ years progressive network management experience in healthcare.
• Experience negotiating managed care contracts with hospital systems.
• Analyze financial impact of contract terms and reimbursement rates.
• Proficient in Microsoft Office.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, terms, amendments, renewals, and value-based arrangements.
• Evaluate reimbursement methodologies, including DRG, PD, Case Rates, POC, OP fee schedules, and alternative payment arrangements.
• Partner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations to ensure contracts are financially sound and operationally executable.
• 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.
• Assist in identifying and recruiting providers based on network needs.

Skills

Hospital contracting

Medicare knowledge

Contract negotiations

Reimbursement methodologies

Data analysis

Leadership

Microsoft Office

Education

Bachelor's degree

Master's degree

Tools

Microsoft Office Suite

Job description

Humana Inc. is seeking a Senior Hospital Contracting Strategist/Negotiator to initiate, negotiate and execute hospital and provider contracts, reporting to the Director, Provider Contracting.

This role leads negotiations, analyzes financial impact, and coordinates with Finance, Legal, and Network Management to ensure contracts are financially sound. The position offers a remote role with travel as needed, pays a base range reflecting market rates, and eligibility for a bonus incentive plan.