# Senior Provider Contracting Professional

**Company**: Humana Inc.
**Location**: Remote Missouri
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $78,400 - $107,800 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Missouri/Senior-Provider-Contracting-Professional_R-433808?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/senior-provider-contracting-professional-a1f6d773-91c/

## Description

The Senior Provider Contracting Professional in the Central Region initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements.

**Key Responsibilities**

- Lead provider contracting activity for assigned markets, providers, and provider types within assigned territory.

- Negotiate and execute provider agreements, amendments, renewals, and terminations in alignment with enterprise network strategy.

- Develop and maintain productive relationships with physician, provider groups, ancillary providers, and hospitals.

- Resolve complex provider issues related to contract interpretation, escalations, and relationship management.

- Partner with internal stakeholders to ensure provider contracts support affordability, quality, network adequacy, growth, and member access objectives.

- Evaluate financial and operational impacts of proposed contract terms and reimbursement models.

- Support implementation of shared savings value-based arrangements and quality rewards programs, where applicable.

- Ensure contract terms comply with Humana policies, state and federal regulations, and internal governance requirements.

- Collaborate with matrixed teams including legal, finance, network operations, credentialing, provider engagement, and clinical leadership.

**Required Qualifications**

- Bachelor's degree.

- 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.

- Experienced 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.

- Proficiency in MS Office applications.

**Preferred Qualifications**

- Master's Degree.

- Experience with ACO/Risk Contracting.

- Experience with Value-Based Contracting.

**Additional Information**

- Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested.

- Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

**Scheduled Weekly Hours**

- 40

**Pay Range**

- $78,400 - $107,800 per year

**Description of Benefits**

- Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities.

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## Skills

### Required
- MS Office applications
- network management
- managed care contracts
- financial analysis
- communication

### Nice to have
- ACO/Risk Contracting
- Value-Based Contracting
- Master's Degree

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Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Missouri/Senior-Provider-Contracting-Professional_R-433808?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)