Director, Provider Contracting
Humana Inc, Olympia, WA, United States
Overview
The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and other provider contracts and agreements. The role manages a 3-state territory (Washington, Oregon, and Alaska) and supports the development and maintenance of a quality network for Humana members, driving strategic goals, enhancing network composition, and improving operational and financial performance. 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. Assists with identifying and recruiting providers based on network composition and needs. Implements strategic plans, drives goals and objectives, and improves performance. Provides input into function strategy. Leads a team of contracting executives and contracting professionals. Travels at least once a quarter. Required Qualifications
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 team building. Proven contract preparation skills and 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. Preferred Qualifications
Master's or J.D. Degree. 8+ years of experience with ACO/Risk Contracting. 8+ years of experience in value‑based contracting. Benefits
Scheduled Weekly Hours: 40 hours per week. Pay Range: $138,900 – $191,000 per year (based on geographic location and individual qualifications). Eligibility for bonus incentive plan based on company and/or individual performance. Comprehensive benefits package including medical, dental, vision, 401(k) retirement savings plan, paid time off, disability insurance, life insurance, paid parental and caregiver leave, and other opportunities. Equal Opportunity Employer
Humana is an equal opportunity employer. We do not 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. We hold to affirmative action and compliance with the Rehabilitation Act, VEVRAA, and all applicable federal civil rights laws.
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The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and other provider contracts and agreements. The role manages a 3-state territory (Washington, Oregon, and Alaska) and supports the development and maintenance of a quality network for Humana members, driving strategic goals, enhancing network composition, and improving operational and financial performance. 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. Assists with identifying and recruiting providers based on network composition and needs. Implements strategic plans, drives goals and objectives, and improves performance. Provides input into function strategy. Leads a team of contracting executives and contracting professionals. Travels at least once a quarter. Required Qualifications
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 team building. Proven contract preparation skills and 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. Preferred Qualifications
Master's or J.D. Degree. 8+ years of experience with ACO/Risk Contracting. 8+ years of experience in value‑based contracting. Benefits
Scheduled Weekly Hours: 40 hours per week. Pay Range: $138,900 – $191,000 per year (based on geographic location and individual qualifications). Eligibility for bonus incentive plan based on company and/or individual performance. Comprehensive benefits package including medical, dental, vision, 401(k) retirement savings plan, paid time off, disability insurance, life insurance, paid parental and caregiver leave, and other opportunities. Equal Opportunity Employer
Humana is an equal opportunity employer. We do not 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. We hold to affirmative action and compliance with the Rehabilitation Act, VEVRAA, and all applicable federal civil rights laws.
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