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Humana is a Fortune 50 market leader in integrated healthcare whose dream is to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana starts from within, and is committed to providing progressive benefits that advance the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.

The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance directly and through leadership of a team develop and maintain a quality network for Humana members. Decisions are typically related to the implementation of new/updated agreements, expansion of networks, programs or large-scale projects and support operational and financial performance. This position will manage a 3-state territory of Washington, Oregon, and Alaska.

Responsibilities include, but are not limited to:

• 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

• Implements strategic plans, drives goals and objectives, and improves performance

• Provides input into functions strategy

• Leads a team of contracting executives and contracting professionals

• Travel once a quarter at minimum

Use your skills to make an impact
 

Required Qualifications  

• Bachelor's Degree

• 8 years of healthcare and/or health insurance experience

• 4 years of experience with provider experience and/or provider contracting

• 4 years of proven leadership experience, including teambuilding

• Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies

• Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

Preferred Qualifications

• Master's or J.D. Degree

• 8 years of experience with ACO/Risk Contracting

• 8 years of experience of Value based contracting experience

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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 required; 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.

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.

 

$138,900 - $191,000 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 competi