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Director, Provider Contracting

Humana - Columbus, OH

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Job Description

Become a part of our caring community and help us put health first The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for the State of Ohio. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment. 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. Leads the Contracting Team for the Midwest Region. Use your skills to make an impact Required Qualifications + 5+ years of provider contracting experience to include contract preparation, contract negotiation and implementation, financial analysis and rate proposal development + Proven leadership experience, including teambuilding + 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 the region (OH, IN, KY, WV, MI) Preferred Qualifications + Bachelor's Degree + Experience with ACO/Risk Contracting + Value based contracting experience Additional Information This role is

Created: 2026-02-04

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