Senior Hospital Contracting Strategist

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.

Responsibilities

• Lead negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value‑based agreements.
• Apply extensive managed care experience with expertise in hospital contracting, reimbursement methodologies, financial analysis, complex negotiations, provider relationship management, and leadership.
• Work 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 identify and recruit providers based on network composition and needs.

Requirements

• Bachelor’s degree.
• 5+ years of hospital negotiation experience in Medicare.
• Experience leading negotiations for hospital and health system agreements, including reimbursement, contract terms, amendments, renewals, and value‑based agreements.
• 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.

Qualifications

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

Skills

• Proficient in Microsoft Office: Word, Excel, and PowerPoint.

Benefits

Humana offers competitive benefits that support whole‑person well‑being, including medical, dental, and vision benefits; a 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; and many other opportunities.

Pay

The compensation range is $78,400 – $10