Director, Provider Contracting

🔥 7 minutes ago

🦌 Connecticut, Maine, +8 more states – Remote

🦌 Connecticut – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🍁 Vermont – Remote

💵 $138.9k - $191k / year

⏰ Full Time

🔴 Lead

👔 Director

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Initiate, negotiate, and execute physician, hospital, and/or other provider contracts and agreements • Communicate contract terms, payment structures, and reimbursement rates to providers • Analyze the financial impact of contracts and terms • Maintain contracts and documentation within a tracking system • Assist with identifying and recruiting providers based on network composition and needs • Implement new or updated programs and large-scale projects • Support technical and operational procedures and processes • Implement strategic plans and drive goals and objectives • Improve performance • Provide input into function strategy • Lead people or projects

🎯 Requirements

• 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 • In-depth knowledge of Medicare contracting, including Value Based/Incentive contracting experience • Must live within the Northeast Region: Maryland, Washington DC, Delaware, Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Maine, New Hampshire, Vermont, or Rhode Island • Master’s degree in business administration or finance preferred • Experience with ACO/Risk Contracting preferred • Minimum 25 Mbps download and 10 Mbps upload internet service • Wireless, wired cable, or DSL connection suggested • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based upon company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Occasional travel to Humana offices for training or meetings may be required