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Director, Provider Contracting

Humana -
North Carolina

Apply Now

Job Details

Full-time
$138,900 - $191,000 a year
6 days ago

Benefits

Paid parental leave
Caregiver leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Parental leave
Vision insurance
Life insurance

Qualifications

Team leadership
Contract management experience in healthcare
Financial analysis
Bachelor's degree
Health insurance knowledge
Direct contracting
Contracts
Leading team collaboration initiatives
Healthcare reimbursement methods
Financial acumen
Analytics

Full Job Description

Become a part of our caring community

The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

The Director, Provider Contracting negotiates contract terms, payment structures, and reimbursement rates to providers across the state for both Medicare Advantage and Medicaid products. Able to work with detailed analytics to understand and communicate financial impact of contracts and terms. Works within multiple systems and tools to maintain contracts and contract details. Leads efforts with identifying and recruiting providers based on network composition and needs. Engagement and decision-making responsibilities related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes. Implements strategic plans, drives goals and objectives, supports operational improvement efforts, and improves performance. Leads contracting team and drives provider relationship.

Use your skills to make an impact

Required Qualifications

Bachelor's Degree
Extensive provider contracting experience
Proven leadership experience, including teambuilding
Proven contract preparation skills, with an in-depth knowledge of Medicare and other reimbursement methodologies
Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
Must live within reasonable driving distance to the State of South Carolina and be willing and able to travel within the region, on occasion

Preferred Qualifications

Master's or J.D. Degree
Experience with ACO/Risk Contracting
Value based contracting experience

Additional Information

This role is "remote/work at home", however, you must live within or in close proximity to the State of South Carolina to be considered for this opportunity. Minimal travel is expected, likely for team meetings or in-person provider meetings.

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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

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.

$138,900 - $191,000 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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 Now

Refine Your Search

project director jobs in north carolina

Director, Provider Contracting

Director, Continuous Improvement

Senior Director

Sr. Director, LPS Fulfillment

Director HR

Senior Project Lead Field Director

Learning and Development Manager

Director, Program Management Strategic Capital Project (North Carolina)

Add Health Research Project Director

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Project Director - Healthcare

AD / Director - Project Management, Non-Interventional Studies Team - Remote based in the US

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SR. DIRECTOR, RETENTION PARTNERSHIPS & BEST PRACTICES (REMOTE)

Managing Director - Head of Software Development, Development

Design Director

Clinical Sr Project Manager / Assoc Director (Global role, Multisponsor) Remote US & Canada

Facility Management Director

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