Senior Hospital Contracting Strategist - Remote

Humana Inc; Madison (WI); Remote; USD 78,000 - 108,000; Full time

Job summary

Humana Inc. is seeking a Senior Hospital Contracting professional to initiate, negotiate, and execute hospital and provider contracts. This remote role reports to the Director, Provider Contracting and involves leading hospital-system negotiations, financial analysis, and network management.

You will collaborate with Finance, Legal, Network Management, Claims, and Operations to ensure contracts are financially sound and operationally executable, while identifying providers to expand the network.

Qualifications

• Bachelor's degree.
• 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.
• Experienced in negotiating managed care contracts with Hospital systems inclusive of 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.
• Engage in extensive managed care negotiations with hospital systems and providers.
• Communicate contract terms and reimbursement rates to providers.
• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• Support provider recruitment based on network needs.

Skills

Hospital contracting

Negotiation

Financial analysis

Provider relationship management

Medicare Advantage

Medicaid

Value based contracting

Reimbursement methodologies

DRG / PD / Case Rates

Microsoft Office

Education

Bachelor's degree

Master's Degree

Tools

Microsoft Word

Excel

PowerPoint

Job description

Humana Inc. is seeking a Senior Hospital Contracting professional to initiate, negotiate, and execute hospital and provider contracts. This remote role reports to the Director, Provider Contracting and involves leading hospital-system negotiations, financial analysis, and network management.

You will collaborate with Finance, Legal, Network Management, Claims, and Operations to ensure contracts are financially sound and operationally executable, while identifying providers to expand the network.