Director Provider Contracting

Become a part of our caring community and help us put health first
 The Director, Provider Contracting serves as a strategic leader overseeing contracting activities for physician, hospital, and other provider agreements within two of the largest markets in Texas for a health insurance organization. This role leads a team of hospital and physician contracting professionals, guiding their work, setting clear objectives, and supporting professional growth and performance management. The Director is responsible for developing and executing market-specific contracting strategies, providing direction and oversight throughout the negotiation process, and actively participating in key negotiations with provider organizations. The Director ensures that contracting initiatives are aligned with organizational goals and regulatory requirements, requiring an in-depth understanding of how capabilities interrelate across functions and segments. This position also fosters collaboration within the team and with internal stakeholders to drive successful outcomes and support the organization’s overall objectives.

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
 

Required Qualifications

• Bachelor's Degree or 8 years of combined leadership and contract negotiation experience
• Extensive provider contracting experience
• 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
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

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

Additional Information

Work-At-Home Requirements:

• WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.  
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

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

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$138,900 - $191,000 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.

About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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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, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.