Become a part of our caring community and help us put health first
 

The Director, Provider Contracting initiates, negotiates, and executes complex physician, hospital, and/or other provider contracts and agreements for an organization. The Director, Provider Contracting leads and develops a team of high performing contractors. The role requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

• The Director, Provider Contracting negotiates complex value-based contract terms, payment structures, and reimbursement rates with sophisticatedproviders.
• 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 and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.
• Provides input into functions strategy.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree

• 5 years of extensive provider contracting experience inclusive of all provider types

• 5 years of Medicare experience

• Proven leadership experience, including teambuilding

• Comfortable with hiring and building teams

• 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

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Must be willing to travel up to 20%

Preferred Qualifications

• Master's or J.D. Degree
• Experience with ACO/Risk Contracting
• Value based contracting experience
• Prefer applicants to be located in AZ, CA, CO, NV, or NM

Additional Information

• Work at Home Requirements

  • Must have the ability to provide a high speed DSL or cable modem for a home office (satellite and wireless internet service is NOT allowed for this role). Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
  • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. 
  • A dedicated space conducive to learning and keeping protected health information (PHI / HIPAA) of our members confidential. Your designated work location must be located away from other household distractions, including but not limited to ensuring that alternate caregiving arrangements are made for dependents or other members in the household.
  • As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. Modern Hire 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.  If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a HireVue interview. In this interview, you will listen to a set of interview questions over your phone, and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
  • Alert:  Humana values personal identity protection.  Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

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