Senior Provider Contracting Specialist (Remote)

Humana; Nashville (TN); On-site; USD 78,000 - 108,000; Full time

Job summary

Humana is seeking a Senior Provider Contracting Professional to initiate, negotiate, and execute contracts with hospitals, physicians, and other providers. The role involves analyzing financial impact, terms, and reimbursement structures while maintaining robust provider relationships across the behavioral health network.

The candidate will engage with C-suite and senior leaders, manage large accounts, and collaborate across departments to drive outcomes aligned with Humana’s consumer-focused

Qualifications

• 3-4 years of progressive network management experience including hospital contracting.
• Medicaid behavioral health contracting experience, to include contract negotiation.
• Medicaid provider relations experience.
• Experience negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems.
• Proficiency in analyzing, understanding, and communicating the financial impact of contract terms, payment structures, and reimbursement rates.

Responsibilities

• Negotiate hospital and ancillary contracts at market competitive pricing.
• Initiate and maintain productive long-term relationships with key hospital and group practice administrators and members.
• Communicate proactively with other departments to ensure effective and efficient business results.
• Handle services, levels of care, and pricing on the behavioral health network side.
• Subject matter expert on the assigned region/behavioral health network.
• Manage large accounts and/or provider relations.
• Be comfortable with C-suite interactions, both internally and externally.

Skills

Network management

Medicaid contracting

Provider relations

Contract negotiation

Financial analysis

Education

Bachelor’s Degree

Job description

Humana is seeking a Senior Provider Contracting Professional to initiate, negotiate, and execute contracts with hospitals, physicians, and other providers. The role involves analyzing financial impact, terms, and reimbursement structures while maintaining robust provider relationships across the behavioral health network.

The candidate will engage with C-suite and senior leaders, manage large accounts, and collaborate across departments to drive outcomes aligned with Humana’s consumer-focused