Senior Provider Contracting Professional

Become a part of our caring community and help us put health first
 

The Senior Provider Contracting Professional serves as a primary point of contact for Humana’s provider partners, driving the negotiation and execution of contracts with physicians, hospitals, and other healthcare organizations. This role manages complex contract assignments requiring thorough analysis and evaluation of various factors and data. By aligning provider agreements with Humana’s strategic goals, the Senior Provider Contracting Professional helps ensure network adequacy, competitive reimbursement structures, and compliance with regulatory requirements. Through effective relationship management and analytical decision-making, this position supports Humana’s commitment to delivering high-quality, cost-effective healthcare, advancing our business objectives, and strengthening our market position.

Location: remote however strong preference for NV, HI, NM, AZ, CO, CA – must work in PST time zone

The Senior Provider Contracting Professional plays a key role in managing provider relationships and advancing network strategy. Responsibilities include clearly communicating contract terms, payment structures, and reimbursement rates to providers; analyzing the financial impact of contracts; and maintaining accurate contract documentation within a tracking system. This role may also assist with identifying and recruiting providers to support network needs. As a Senior Provider Contracting Professional, the professional influences departmental strategy, independently makes decisions on complex project components, and exercises considerable latitude in determining objectives and approaches to assignments.

• Negotiate and manage complex provider contracts.

• Build and maintain relationships with healthcare providers.

• Analyze provider performance and financial impact.

• Collaborate with internal teams to ensure contract compliance.

• Monitor and resolve provider issues related to contracts.

• Identify opportunities for network improvement and cost savings.

• Mentor and support junior contracting staff.

• Report contract status and metrics to leadership.

Use your skills to make an impact
 

Role Essentials

• Bachelor's degree or equivalent work experience

• 4+ years of progressive network management/operations experience including contracting and/or network administration/operations in a healthcare company

• Proficiency in analyzing, understanding and communicating financial impact of contract terms, payment structures and reimbursement rates to providers

• Excellent written and verbal communication skills

• Ability to manage multiple priorities in a fast-paced environment

• Proficiency in MS Office applications

Role Desirables

• Master's Degree

• Experienced in negotiating managed care contracts with large physician groups, ancillary providers and hospital systems

• Experience with ACO/Risk Contracting

• Experience with Value Based Contracting especially in a delegated environment

Additional 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 required; 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.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for you.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 11-24-2025

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.

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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.