Description

Become a part of our caring community
Humana Healthy Horizons is looking for a Provider Contracting Professional who negotiates physician, hospital, and other provider contracts and agreements related to Medicaid health plans. Reporting to the Associate Director, Provider Contracting, you will work assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Provider Contracting Professional responsibilities include

• Analyze financial impact of contracts and terms.
• Maintain contracts and documentation within a tracking system.
• May assist with identifying and recruiting providers based on network composition and needs.
• Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas.
• Make decisions regarding own work methods, occasionally in, and receive guidance where needed.

Use your skills to make an impact

Required Qualifications

o Must work within the eastern standard time zone hours.

o 2+ years of experience in negotiating managed care contracts with physicians, hospitals and/or other provider contracts.

o Strong proficiency with Excel and Word MS Office applications.

Preferred Qualifications

o 2+ years of Medicaid/Medicare network development experience

o Bachelor's degree.

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

o Experience with New Network Management.

o Experience with QuickBase.

Additional Information:

o Workstyle: Remote, work at home.

o Travel: None.

o Core Workdays & Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time.

Interview Format

As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule.

Work at Home Requirements

o At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

o Satellite, cellular and microwave connection can be used only if approved by leadership.

o Associates 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.

o Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

o 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.

$65,000 - $88,600 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: 05-22-2026
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 atHumana.comand atCenterWell.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.
Requisition #: R-415342

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