Senior Hospital Contracting Strategist
for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to parse posting. We need to avoid repeating job title as heading. No Job ID. Remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning, duplicated lines, application instructions. Also remove "Application Deadline: 09-11-2026"? That's application instruction; remove. Also remove "About Us" sections? Those are not part of job posting? Might be considered boilerplate? The instruction: Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. "About Us" maybe not required but could be considered extra info not part of job posting; but it's substantive about company. Might keep? The instruction says preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep About Us info as it's substantive about the company. However we need to fit into sections. Could put under a heading like "About the company" but not in allowed headings list. The allowed headings list is specific; we should only use those headings. If we have content that doesn't fit, we could still include as
without heading? The instruction: Use
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). It doesn't forbid other headings, but says use those for section headings. Probably we should only use those headings when we have content. For other content like "About Us", we could just put as
without heading. But better to include under "About the role"? Not exactly. Could treat "About the role" as description of role; we have that at start. So we can put that under About the role. Responsibilities: list of duties. Requirements: maybe required qualifications. Qualifications: maybe preferred qualifications? Actually they have Required Qualifications and Preferred Qualifications. Could combine? But we have separate headings Requirements and Qualifications. Could put Required Qualifications under Requirements, and Preferred Qualifications under Qualifications. Skills: maybe list of skills like Microsoft Office, negotiation, etc. Could extract. Benefits: description of benefits. Pay: pay range. Schedule: scheduled weekly hours, work hours, travel. We need to avoid filler like "commensurate with experience". Not present. We must not include headings with empty content. Let's extract content. First paragraph: "Become a part of our caring community The Senior Hospital Contracting Strategist / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital and other provider contracts and agreements for an organization that provides health insurance. You will report to the Director, Provider Contracting. As the Senior Hospital Contracting Strategist/ Senior Provider Contracting Professional you will Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements" That's role description. Could go under About the role. Next: "Extensive managed care experience with demonstrated expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadershipExperience with Medicare Advantage, Medicaid, and value based-contractingEvaluate reimbursement methodologies, including DRG, PD, Case Rates, POC, OP fee schedules, and alternative payment arrangementsPartner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations to ensure contracts are financially sound and operationally executableCommunicate contract terms, payment structures, and reimbursement rates to providersAnalyze financial impact of contracts and termsMaintain contracts and documentation within a tracking systemHelp with identifying and recruiting providers based on network composition and needs" These are responsibilities/duties. Could be under Responsibilities as bullet list. Then "Required Qualifications Use your skills to make an impact Bachelor's degree5 or more years of Hospital negotiation experience in MedicareLeading negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare companyExperienced in negotiating managed care contracts with Hospital systems inclusive of post acute, ancillary providers and physicians.Analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers.Understand and interpret Hospital contract languageProficient in Microsoft Office: Word, Excel and PowerPoint" That's required qualifications. Then "Preferred Qualifications Master's DegreeExperience with ACO/Risk ContractingExperience with Value Based Contracting" Then "Additional Information 8am to 5pm EST, Travel based on business needs 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from 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. $78,400 - $107,800 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities." Then "About Us About CarePlus Health Plans: ..." and "About Humana: ..." then EEO. We need to remove EEO boilerplate. Also remove "Application Deadline". Also remove "About Us"? Might be considered extra but could be kept as substantive. However the instruction says preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep About Us info. But we need to place it somewhere. Could add a section "About the company" but not in allowed headings. Maybe we can just put as
after the sections without a heading. That's okay. We must not include headings for empty sections. Thus we will produce:
About the role
Become a part of our caring community The Senior Hospital Contracting Strategist / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital and other provider contracts and agreements for an organization that provides health insurance. You will report to the Director, Provider Contracting. As the Senior Hospital Contracting Strategist/ Senior Provider Contracting Professional you will Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements.
Responsibilities
- Extensive managed care experience with demonstrated expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadership
- Experience with Medicare Advantage, Medicaid, and value based-contracting
- Evaluate reimbursement methodologies, including DRG, PD, Case Rates, POC, OP fee schedules, and alternative payment arrangements
- Partner with Finance, Medical Economics, Legal, Network Management, Claims, Configuration, and Operations to ensure contracts are financially sound and operationally executable
- Communicate contract terms, payment structures, and reimbursement rates to providers
- Analyze financial impact of contracts and terms
- Maintain contracts and documentation within a tracking system
- Help with identifying and recruiting providers based on network composition and needs
Requirements
- Bachelor's degree
- 5 or more years of Hospital negotiation experience in Medicare
- Leading negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value based agreements
- 5 or more years of progressive network management experience including hospital contracting and network administration in a healthcare company
- Experienced in negotiating managed care contracts with Hospital systems inclusive of post acute, ancillary providers and physicians
- Analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers
- Understand and interpret Hospital contract language
- Proficient in Microsoft Office: Word, Excel and PowerPoint
Qualifications
- Master's Degree
- Experience with ACO/Risk Contracting
- Experience with Value Based Contracting
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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Pay
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. $78,400 - $107,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Schedule
Scheduled Weekly Hours: 40. Work hours: 8am to 5pm EST. Travel based on business needs; occasional travel to Humana's offices for training or meetings may be required. Work-at-home requirements: minimum download speed 25 Mbps and upload speed 10 Mbps (wireless, wired cable or DSL suggested); dedicated workspace free of interruptions to protect PHI/HIPAA information; Humana may require internet service upgrade if needed.
Then after that we can add About Us info aswithout heading. About Us: "About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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