Director, Provider Contracting - NC

Become a part of our caring community and help us put health first
 The Director, Provider Contracting, leads and manages the provider networks for all of Humana’s various lines of business through the NC Contracting team. The Director also initiates, analyzes, and negotiates hospital, physician, and/or other provider contracts and agreements for the organization; including value-based arrangements directly with provider groups and integrated systems. The Director, Provider Contracting requires an in-depth understanding of contracting, reimbursement methodology, and financial acumen. The role requires close collaboration with various internal departments and leaders to obtain consensus and ensure the successful execution of contracts and continued provider relationships. The position coordinates the contracting functions with other key Humana areas such as Provider Engagement, Network Operations for contract loads, National Contracting, and other functional leaders across the organization.

• Lead, mentor, and manage a team of contracting professional, fostering a collaborative and high-performance work environment.

• Develop and execute strategic plans for contracting with hospital, physician, ancillary, and valued-based providers.

• Negotiate contract terms, pricing, and conditions with healthcare providers to secure favorable agreements.

• Ensure all contracts comply with company policies, regulatory requirements, and industry standards.

• Collaborate with internal leaders across departments to obtain necessary approvals and align contracting strategies with organizational goals.

• Monitor and evaluate the performance of contracted providers, ensuring high quality care and service delivery.

• Maintain comprehensive documentation and records of all contracts and negotiations.

• Stay informed about industry trends, regulatory changes, and competitive landscape to inform contracting strategies.

• Address and resolve any issues or disputes related to contracts in a timely and effective manner.

• Provide regular reports and updates to senior management on contracting activities, performance, and outcomes.

• Other duties as assigned by senior leadership.

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree
• 5+ years of successfully negotiating and managing contracts with hospitals, physicians, and ancillary providers.
• 3+ years of leadership and team management skills, with the ability to motivate and develop staff.
• Contract preparation, negotiation, and execution skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
• Value based contracting experience
• Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
• Excellent communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.
• Strategic thinker with strong analytical and problem-solving abilities.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Proven track record of accomplishing targets and goals
• Ability and willingness to travel within the region, as required

Preferred Qualifications

• Master's or J.D. Degree
• Experience with ACO/Risk Contracting

​

Additional Information

This position is considered "remote/work at home", however you must be within commutable distance from North Carolina providers.

Work at Home Information

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 recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

#LI-Remote

#LI-JR1

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$136,200 - $187,400 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Apply