Director of Contracting - Network Development- MO IA and NE

Profile

Description

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

Responsibilities

The Director, Provider Contracting communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and documentation within a tracking system. May assist with identifying and recruiting providers based on network composition and needs. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. This position will manage a 3 state territory of MO, IA, and NE.

Must reside or be willing to relocate (will be provided) to MO, IA or NE

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, Commercial and other reimbursement methodologies
Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Proven track record of accomplishing targets and goals
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.


Preferred Qualifications


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


Additional Information

Scheduled Weekly Hours

40

Company info

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