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

Qualifications

• Master's Degree (preferred)
• Experience with ACO/Risk Contracting (preferred)
• Experience with Value Based Contracting (preferred)

Skills

• Extensive managed care experience
• Expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadership
• Experience with Medicare Advantage, Medicaid, and value‑based contracting
• Proficient in Microsoft Office (Word, Excel, PowerPoint)

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
• Additional wellness programs supporting whole‑person well‑being

Pay

$78,400 - $107,800 per year (base pay for full‑time 40‑hour week). 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 reliable internet (minimum 25 Mbps download / 10 Mbps upload) to protect PHI/HIPAA information.