Senior Hospital Contracting Strategist

About the role

The Senior Hospital Contracting Strategist / Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital and other provider contracts and agreements for a health insurance organization. The role reports to the Director, Provider Contracting.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value‑based agreements.
• 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 identify and recruit providers based on network composition and needs.

Qualifications

Required:

• Bachelor’s degree.
• 5+ years of hospital negotiation experience in Medicare.
• 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company.
• Experience negotiating managed care contracts with hospital systems, inclusive of post‑acute, ancillary providers and physicians.
• Ability to analyze, understand and communicate financial impact of contract terms, payment structures and reimbursement rates to providers.
• Ability to understand and interpret hospital contract language.
• Proficient in Microsoft Office: Word, Excel and PowerPoint.

Preferred:

• Master’s degree.
• Experience with ACO/risk contracting.
• Experience with value‑based contracting.

Benefits

• Medical, dental and vision benefits.
• 401(k) retirement savings plan.
• Time off (paid time off, company and personal holidays, paid parental and caregiver leave).
• Short‑term and long‑term disability.
• Life insurance.
• Many other opportunities.

Pay

$78,400 – $107,800 per year (good‑faith estimate for full‑time 40‑hour/week employment). Eligible for a bonus incentive plan based on company and/or individual performance.

Schedule

Standard hours: 8 am to 5 pm EST, 40 hours per week. Occasional travel to Humana offices for training or meetings may be required. Remote work requires a dedicated workspace with internet service of at least 25 Mbps download and 10 Mbps upload (wireless, cable or DSL) to protect member PHI/HIPAA information.