Remote Senior Provider Contracting Lead

Humana; Wisconsin; Remote; USD 78,000 - 108,000; Full time

Job summary

Humana is seeking a Senior Provider Contracting Professional in the Central Region to initiate, negotiate, and execute contracts with physicians, hospitals, and other providers. You will report to the Director, Provider Contracting and partner with legal, finance, and network teams.

The role is remote with occasional travel to Humana offices, 40 hours a week, with a base pay range of $78,400 to $107,800 per year and eligibility for a bonus incentive plan based on performance.

Qualifications

• Bachelor's degree.
• 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.
• Experienced in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems.
• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures, and reimbursement rates to providers.
• Proficiency in MS Office applications.

Responsibilities

• Lead provider contracting activity for assigned markets, providers, and provider types within assigned territory.
• Negotiate and execute provider agreements, amendments, renewals, and terminations in alignment with enterprise network strategy.
• Develop and maintain productive relationships with physician, provider groups, ancillary providers and hospitals.
• Resolve complex provider issues related to contract interpretation, escalations, and relationship management.
• Partner with internal stakeholders to ensure provider contracts support affordability, quality, network adequacy, growth, and member access objectives.
• Evaluate financial and operational impacts of proposed contract terms and reimbursement models.
• Support implementation of shares savings value-based arrangements and quality rewards programs, where applicable.
• Ensure contract terms comply with Humana policies, state and federal regulations, and internal governance requirements.
• Collaborate with matrixed teams including legal, finance, network operations, credentialing, provider engagement, and clinical leadership.

Skills

Provider contracting

Contract negotiation

Financial analysis

MS Office

Relationship management

Education

Bachelor's degree

Master's degree

Job description

Humana is seeking a Senior Provider Contracting Professional in the Central Region to initiate, negotiate, and execute contracts with physicians, hospitals, and other providers. You will report to the Director, Provider Contracting and partner with legal, finance, and network teams.

The role is remote with occasional travel to Humana offices, 40 hours a week, with a base pay range of $78,400 to $107,800 per year and eligibility for a bonus incentive plan based on performance.