Senior Provider Contracting Lead — Remote

Humana, Inc.; Missouri; Hybrid; USD 78,000 - 108,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana, Inc. is seeking a Senior Provider Contracting Professional to lead and execute physician, hospital, and other provider contracts in the Central Region.

You will negotiate terms, renewals, and terminations while aligning with network strategy and affordability goals. You will build relationships with physician groups, hospitals and ancillary providers, analyze financial impact, collaborate with legal, finance and operations, and ensure compliance with policies and regulations.

Qualifications

• Bachelor's degree required.
• 5+ years of progressive network management experience including hospital contracting and network administration.
• Experience negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems.
• Ability to analyze and communicate financial impact of contract terms and reimbursement rates.

Responsibilities

• Lead provider contracting activity for assigned markets, providers and provider types.
• Negotiate and execute provider agreements, amendments, renewals, and terminations.
• Build relationships with physicians, provider groups, ancillaries and hospitals.
• Resolve complex provider issues related to contract interpretation and relationship management.
• Collaborate with stakeholders to ensure contracts support affordability, quality, network adequacy, growth and member access.
• Evaluate financial and operational impacts of proposed contract terms and reimbursement models.
• Support value-based arrangements and quality rewards programs where applicable.
• Ensure contracts comply with Humana policies and regulations.

Skills

Contract negotiation

Financial analysis

Provider contracts

MS Office

Education

Bachelor's degree

Master's degree

Tools

MS Office

Job description

Humana, Inc. is seeking a Senior Provider Contracting Professional to lead and execute physician, hospital, and other provider contracts in the Central Region.

You will negotiate terms, renewals, and terminations while aligning with network strategy and affordability goals. You will build relationships with physician groups, hospitals and ancillary providers, analyze financial impact, collaborate with legal, finance and operations, and ensure compliance with policies and regulations.