Director, Provider Contracting

Humana

1d • Remote

About The Position

Become a part of our caring community and help us put health first The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the state of Illinois. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Provider Contracting 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. 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

Requirements

• Bachelor's Degree
• 2+ years of extensive provider contracting experience inclusive of all provider types
• Proven leadership experience, including teambuilding
• Comfortable with hiring and building teams
• Proven contract preparation skills, with an in-depth knowledge of Medicare, Medicaid, 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

Nice To Haves

• Master's or J.D. Degree
• Experience with ACO/Risk Contracting
• Value based contracting experience

Responsibilities

• Initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the state of Illinois.
• 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.
• 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.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 5,001-10,000 employees