Senior Provider Contracting Professional

Humana Inc. · Remote Missouri · $78,400 - $107,800 per year · remote The Senior Provider Contracting Professional in the Central Region initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. Key Responsibilities Lead provider contracting activity for assigned markets, providers, and provider types within assigned territory. Negotiate and execute provider agreements, amendments, renewals, and terminations in alignment with enterprise network strategy. Develop and maintain productive relationships with physician, provider groups, ancillary providers, and hospitals. Resolve complex provider issues related to contract interpretation, escalations, and relationship management. Partner with internal stakeholders to ensure provider contracts support affordability, quality, network adequacy, growth, and member access objectives. Evaluate financial and operational impacts of proposed contract terms and reimbursement models. Support implementation of shared savings value-based arrangements and quality rewards programs, where applicable. Ensure contract terms comply with Humana policies, state and federal regulations, and internal governance requirements. Collaborate with matrixed teams including legal, finance, network operations, credentialing, provider engagement, and clinical leadership. Required Qualifications Bachelor's degree. 5+ years of progressive network management experience including hospital contracting and network administration in a healthcare company. Experienced in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems. Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures, and reimbursement rates to providers. Proficiency in MS Office applications. Preferred Qualifications Master's Degree. Experience with ACO/Risk Contracting. Experience with Value-Based Contracting. Additional Information 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. 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 $78,400 - $107,800 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities.