[Hiring] Director, Provider Contracting @Humana

Role Description

The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

• Communicates contract terms, payment structures, and reimbursement rates to providers.
• Analyzes financial impact of contracts and terms.
• Maintains contracts and documentation within a tracking system.
• May assist with identifying and recruiting providers based on network composition and needs.
• Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function.
• Implements strategic plans, drives goals and objectives, and improves performance.
• Provides input into functions strategy.

Qualifications

• Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital and value-based contracting.
• A minimum of 5 years contracting experience to include hospital and value-based contracting.
• Experience leading people or projects.
• Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena.
• Proven contract preparation and negotiation skills, with an in-depth knowledge of Medicare contracting including Value Based/Incentive contracting experience.
• Must live within the Northeast Region (MD, DC, DE, PA, NJ, NY, CT, MA, ME, NH, VT, RI).

Requirements

• Master’s degree in business administration or finance (preferred).
• Experience with ACO/Risk Contracting (preferred).

Benefits

• Competitive benefits that support whole-person well-being.
• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.