The Senior Provider Contracting Professional initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements. The Senior Provider Contracting Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Provider Contracting Professional communicates contract terms, payment structures, and reimbursement rates to providers. Provides a comprehensive hospital network to consumers in the behavioral health arena and executes on Humana's consumer-focused business strategy. The Senior Provider Contracting Professional will negotiate with a variety of provider constituencies and provide continual re-prioritization of corporate and consumer needs. 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. Exercises considerable latitude in determining objectives and approaches to assignments. In this role you will:
Negotiate hospital and ancillary contracts at market competitive pricing
Initiate and maintain productive long-term relationships with key hospital and group practice administrators and members
Communicate proactively with other departments in order to ensure effective and efficient business results
Handle services, levels of care, and pricing on the behavioral health network side
Subject matter expert on the assigned region/behavioral health network
Manage large accounts and/or provider relations
Be comfortable with C-suite interactions, both internally and externally
Use your skills to make an impact
Required Qualifications
3-4 years of progressive network management experience including hospital contracting and network administration in a healthcare company or healthcare system
Medicaid behavioral health contracting experience, to include contract negotiation
Medicaid provider relations experience
Experienced in negotiating managed care contracts with large physician groups, ancillary providers, and hospital systems
Proficiency in analyzing, understanding, and communicating the financial impact of contract terms, payment structures, and reimbursement rates to providers
Role Desirables
Additional Information
This role is "remote/work at home" and can be based anywhere in the United States, however, preference will be given to candidates that are located in the Eastern or Central Time Zone.
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
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.
$78,400 - $107,800 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.
Application Deadline: 08-21-2026
