Director, Provider Contracting

This is a fully remote position, open to applicants in Connecticut, +9 more states.

📋 Description

• Initiate, negotiate, and finalize contracts and agreements with physicians, hospitals, and other healthcare providers.

• Clearly communicate contract terms, payment structures, and reimbursement rates to providers.

• Evaluate the financial implications of contracts and their terms.

• Maintain contracts and documentation within a comprehensive tracking system.

• Assist in identifying and recruiting providers based on the needs and composition of the network.

• Implement new or updated programs and oversee large-scale projects.

• Support technical and operational procedures and processes.

• Execute strategic plans and drive towards achieving goals and objectives.

• Enhance overall performance.

• Contribute insights into functional strategy.

• Lead teams or projects effectively.

⛳️ Requirements

• Bachelor’s Degree in Business, Finance, or a related field; or a minimum of 10 years of experience in provider contracting, including hospital and value-based contracting.

• At least 5 years of contracting experience, encompassing hospital and value-based contracting.

• Proven ability in leading teams or projects.

• Strong financial acumen, with expertise in analyzing and interpreting financial trends in provider contracting.

• Established skills in contract preparation and negotiation.

• Comprehensive knowledge of Medicare contracting, including experience with Value Based/Incentive contracting.

• Must reside within the Northeast Region: Maryland, Washington DC, Delaware, Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Maine, New Hampshire, Vermont, or Rhode Island.

• A Master’s degree in business administration or finance is preferred.

• Experience with ACO/Risk Contracting is preferred.

• Minimum internet service requirements of 25 Mbps download and 10 Mbps upload.

• Suggested connection types include wireless, wired cable, or DSL.

• A dedicated workspace free from ongoing interruptions to safeguard member PHI/HIPAA information is essential.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Comprehensive medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability coverage.

• Long-term disability coverage.

• Life insurance.

• Occasional travel to Humana offices for training or meetings may be required.