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 an organization that provides health insurance. You will report 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 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.
• 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.
• 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 Qualifications

• 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 supporting whole‑person well‑being.

Pay

$78,400 - $107,800 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Schedule

8am to 5pm EST, with occasional travel to Humana's offices for training or meetings as needed.