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

The Director, Provider Contracting leads the team that evaluates and assesses interests in joining the Humana Primary Care Network. This includes, but is not limited to, negotiation support, value-based acumen, technologies, and/or other key provider systems, processes and procedures. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment specifically in global risk Medicare environment. This role acts as the first step into joining Humana’s value-based centric Primary Care Network.

The Director, Provider Contracting guides a team that reviews Letters of Interests (“LOI”) and requests to join the network and provides expertise based on State/Market dynamics. This includes communicating contract terms, payment structures, and reimbursement rates to providers as well as evaluation of the entity’s wherewithal to be successful in a Global Risk environment maximizing quality, profitability, and growth of Humana’s products. The Director, Provider Contracting supports and analyzes financial impact of contracts and terms and can effectively communicate value to both internal and external leaders. Maintains contracts and documentation within a tracking system and able to provide executive level summaries of recommendations, changes and impacts. 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.

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with generous employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree
• Minimum of 5 years of hands-on value-based provider contracting experience
• Proven leadership experience, including teambuilding across multiple geographies
• Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
• Strong financial acumen with proficiency in analyzing, interpreting, and applying financial trends in the provider contracting arena
• Must live within the State of Florida
• Willing to travel to Humana's Miramar office as required

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Preferred Qualifications

• Advanced Degree
• Market development and membership growth experience
• Grass roots marketing
• Medicare Advantage experience
• Experience with ACO/Risk Contracting

Additional Information

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

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

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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.