Senior Provider Contracting Leader (Remote)

Humana; Missouri; 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 physician, hospital, and other provider contracts. You will report to the Director, Provider Contracting and collaborate with Legal, Finance, and Clinical leaders.

The role supports remote work with travel to Humana offices as needed and involves 40 hours per week with eligibility for bonus based on performance. Strong negotiation and financial analysis skills are essential.

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

Contract negotiation

Financial analysis

Relationship building

Stakeholder communication

Education

Bachelor's degree

Master's Degree

Tools

MS Office

Job description

Humana is seeking a Senior Provider Contracting Professional in the Central Region to initiate, negotiate, and execute physician, hospital, and other provider contracts. You will report to the Director, Provider Contracting and collaborate with Legal, Finance, and Clinical leaders.

The role supports remote work with travel to Humana offices as needed and involves 40 hours per week with eligibility for bonus based on performance. Strong negotiation and financial analysis skills are essential.