Director, Provider Contracting

Humana • Wyoming, MI

2d • Remote

About The Position

Become a part of our caring community 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.

Requirements

• 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

Nice To Haves

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

Responsibilities

• 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

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