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The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Senior Provider Contracting Professional 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.. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Use your skills to make an impact
 

Required Qualifications

• Minimum of 3 years of progressive experience in network management, with a specific emphasis on advanced contracting for Primary Care Providers, Physician Groups, or Managed Service Organizations (MSOs) within the healthcare sector.
• Demonstrated expertise in negotiating Value-Based and managed care agreements with large physician organizations, particularly in support of Medicare and Medicaid Lines of Business contracting initiatives.
• Advanced ability to analyze, interpret, and clearly communicate the financial implications of contract terms, payment methodologies, and provider reimbursement structures.
• Exceptional written and verbal communication skills, supporting effective collaboration and negotiation with internal and external stakeholders.
• Proven capacity to successfully manage multiple, concurrent priorities in a dynamic, fast-paced environment.
• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Outlook) to support contract analysis, presentations, and documentation.
• Must live in the State of Florida, with the ability and willingness to travel within the state up to 25% of the time as required for provider engagement and contracting activities.

Preferred Qualifications

• Bachelor's degree
• Experience with ACO/Risk Contracting
• Experience with Value Based Contracting

Additional Information

This role is considered "remote/work at home", however, you must reside in the State of Florida to be considered for this opportunity.

Work at Home Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

#LI-Remote

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$78,400 - $107,800 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off