Senior Hospital Contracting Strategist

🕒 August 20

🏈 Alabama, Arizona, +41 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 23%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 other provider contracts and agreements • Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value-based agreements • Evaluate reimbursement methodologies, including DRG, PD, case rates, POC, outpatient fee schedules, and alternative payment arrangements • Partner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations • Ensure contracts are financially sound and operationally executable • 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 • Help identify and recruit providers based on network composition and needs • Report to the Director, Provider Contracting

🎯 Requirements

• Bachelor's degree • 5 or more years of hospital negotiation experience in Medicare • 5 or more years of progressive network management experience, including hospital contracting and network administration in a healthcare company • Extensive managed care experience • Demonstrated expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadership • Experience with Medicare Advantage, Medicaid, and value-based contracting • Experience negotiating managed care contracts with hospital systems, including post-acute, ancillary providers, and physicians • Ability to analyze, understand, and communicate the financial impact of contract terms, payment structures, and reimbursement rates to providers • Ability to understand and interpret hospital contract language • Proficiency in Microsoft Word, Excel, and PowerPoint • Self-provided internet service with minimum 25 Mbps download and 10 Mbps upload speeds • Ability to work from a dedicated space without ongoing interruptions to protect PHI/HIPAA information • Availability to work 8 a.m. to 5 p.m. EST • Willingness to travel based on business needs • Master's degree preferred • Experience with ACO/risk contracting preferred • Experience with value-based contracting preferred

🏖️ Benefits

• Bonus incentive plan based on 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 • Remote work arrangement • Occasional travel to Humana offices for training or meetings • Internet service upgrade support if required for business needs