Senior Hospital Contracting Strategist - Value-Based

Humana Inc; Austin (TX); Remote; USD 78,000 - 108,000; Full time

Job summary

Humana Inc. is seeking a Senior Hospital Contracting professional to initiate, negotiate, and execute physician, hospital and provider contracts for a health insurance organization.

The role reports to the Director, Provider Contracting and involves leading complex negotiations with hospital systems, evaluating reimbursement methodologies, and coordinating with Finance, Legal and Network Management to ensure contracts are financially sound.

Qualifications

• Bachelor's degree required.
• 5+ years hospital negotiation experience in Medicare.
• Experience leading hospital and health system contract negotiations.
• Progressive network management experience including hospital contracting.
• Experience negotiating managed care contracts with hospital systems.
• Ability to analyze financial impact and communicate terms to providers.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value-based agreements.
• Evaluate reimbursement methodologies and contract terms.
• Collaborate with Finance, Legal, Network Management and Operations to ensure contracts are financially sound and operationally executable.
• Communicate contract terms, payment structures and reimbursement rates to providers.
• Maintain contracts and documentation within a tracking system.
• Help identify and recruit providers based on network composition and needs.

Skills

Negotiation leadership

Relationship management

Financial analysis

Contract language interpretation

Communication of terms to providers

Education

Bachelor's degree

Master's degree

Tools

Word

Excel

PowerPoint

Job description

Humana Inc. is seeking a Senior Hospital Contracting professional to initiate, negotiate, and execute physician, hospital and provider contracts for a health insurance organization.

The role reports to the Director, Provider Contracting and involves leading complex negotiations with hospital systems, evaluating reimbursement methodologies, and coordinating with Finance, Legal and Network Management to ensure contracts are financially sound.