Humana
Senior Provider Contracting Professional
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Senior Provider Contracting Professional
role at
Humana .
Base Pay Range $78,400 - $107,800 per year
Job Summary The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The role involves moderately complex issues requiring analysis of situations. Responsibilities include communicating contract terms, payment structures, and reimbursement rates to providers; analyzing financial impacts; maintaining contracts and documentation within a tracking system; assisting with provider recruitment; making decisions on moderately complex projects; and exercising latitude in determining objectives and approaches.
Required Qualifications
Bachelor’s Degree and/or equivalent experience
5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
Experience in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems
Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures, and reimbursement rates to providers
Demonstrated ability to articulate ideas effectively in both written and oral forms
Ability to manage multiple priorities in a fast‑paced environment
Proficiency in MS Office applications
Preferred Qualifications
Experience contracting for Medicaid in Washington State
Master's Degree
Experience with ACO/Risk Contracting
Experience with Value-Based Contracting
Additional Information
Minimum download speed of 25 Mbps (upload 10 Mbps); wired or wireless connection recommended
Satellite, cellular, and microwave connections permitted only with leadership approval
Employees working from home in California, Illinois, Montana, or South Dakota receive a bi‑weekly internet expense payment
Humana will provide telephone equipment as needed
Work from a dedicated space that protects member PHI/HIPAA information
SSN Alert:
Humana values personal identity protection. Applicants may be asked to provide their Social Security Number. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information to the application.
Travel: While this is a remote position, occasional travel to Humana offices for training or meetings may be required.
Scheduled Weekly Hours 40
Benefits Humana offers competitive benefits including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off; disabled and life insurance; and other opportunities to support well‑being.
About Us Humana Inc. (NYSE: HUM) is committed to putting health first— for teammates, customers, and the company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for people to achieve their best health.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action to employ and advance individuals with disability or protected veteran status, basing all employment decisions only on valid job requirements. This policy applies to all employment actions.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Information Technology
Industry Insurance
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Senior Provider Contracting Professional
role at
Humana .
Base Pay Range $78,400 - $107,800 per year
Job Summary The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The role involves moderately complex issues requiring analysis of situations. Responsibilities include communicating contract terms, payment structures, and reimbursement rates to providers; analyzing financial impacts; maintaining contracts and documentation within a tracking system; assisting with provider recruitment; making decisions on moderately complex projects; and exercising latitude in determining objectives and approaches.
Required Qualifications
Bachelor’s Degree and/or equivalent experience
5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
Experience in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems
Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures, and reimbursement rates to providers
Demonstrated ability to articulate ideas effectively in both written and oral forms
Ability to manage multiple priorities in a fast‑paced environment
Proficiency in MS Office applications
Preferred Qualifications
Experience contracting for Medicaid in Washington State
Master's Degree
Experience with ACO/Risk Contracting
Experience with Value-Based Contracting
Additional Information
Minimum download speed of 25 Mbps (upload 10 Mbps); wired or wireless connection recommended
Satellite, cellular, and microwave connections permitted only with leadership approval
Employees working from home in California, Illinois, Montana, or South Dakota receive a bi‑weekly internet expense payment
Humana will provide telephone equipment as needed
Work from a dedicated space that protects member PHI/HIPAA information
SSN Alert:
Humana values personal identity protection. Applicants may be asked to provide their Social Security Number. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information to the application.
Travel: While this is a remote position, occasional travel to Humana offices for training or meetings may be required.
Scheduled Weekly Hours 40
Benefits Humana offers competitive benefits including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off; disabled and life insurance; and other opportunities to support well‑being.
About Us Humana Inc. (NYSE: HUM) is committed to putting health first— for teammates, customers, and the company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for people to achieve their best health.
Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action to employ and advance individuals with disability or protected veteran status, basing all employment decisions only on valid job requirements. This policy applies to all employment actions.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Information Technology
Industry Insurance
#J-18808-Ljbffr