Strategic Provider Contracting Leader - Remote

Humana; Minnesota; 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 contracts for physician, hospital, and other providers. You will report to the Director, Provider Contracting, and lead contracting activity for assigned markets and provider types.

The role requires 5+ years in healthcare network management, strong negotiation and financial analysis skills, and the ability to collaborate with legal, finance, network operations, credentialing,

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

Negotiation

Financial analysis

MS Office proficiency

Education

Bachelor's degree

Job description

Humana is seeking a Senior Provider Contracting Professional in the Central Region to initiate, negotiate, and execute contracts for physician, hospital, and other providers. You will report to the Director, Provider Contracting, and lead contracting activity for assigned markets and provider types.

The role requires 5+ years in healthcare network management, strong negotiation and financial analysis skills, and the ability to collaborate with legal, finance, network operations, credentialing,