Director, Network Contracting and Support
Humana
Become a part of our caring community and help us put health first
The Director, Network Contracting and Support (Director, Contract Tools, Education, Processes) supports successful national and market level facility and fee-for-service provider relationships with a focus on improving the provider experience and achieving enterprise network optimization goals. The position requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Director, Network Contracting and Support (Director, Contract Tools, Education, Processes) 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 role will be directly responsible for several key areas, including strategic direction and ongoing operational oversight of the contract governance committee (e.g. CSA), contract language review (e.g. NLRG), and the Merlin/iCertis teams. In addition, this role serves as the national subject matter expert for hospital/IDN contracting/negotiation principles and integrating new IDN.
- Responsible for the strategic development and implementation of operations, contract negotiations support, and business owner of Contract Strategy Approval Committee (CSA) and like governance processes
- Responsible for leading and overseeing National Language Resource Group (NLRG) team. Works collaboratively with the National Template team to ensure the latest template/language updates are being utilized by market teams
- Work collaboratively with senior leadership and multiple enterprise departments to drive best practices in facility, IDN and fee-for-service contracting
- Ensures the resolution of the development, expansion, and overall success of national contracting Key Performance Indicators and Best Practices
- Develops and maintains market tools and resources to support facility,IDN and fee-for-service contract negotiations
- Support expansion and usage of the Merlin/iCertis contract management system including collaborating with enterprise partners to ensure workflow optimization in the end-to-end contracting process
- Manage a team of 6-10 direct reports
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Use your skills to make an impact
Required Qualifications
- Bachelor’s Degree
- 5+ years of managed care market operations experience
- 2+ years of people leadership experience with the ability to work collaboratively and influence others
- 2+ years of strong project management skills with experience working on mid to large scale projects
- 2+ years’ hospital contracting negotiation experience and/or knowledge of facility payment/reimbursement methodologies
- Excellent communication skills, written and verbal
- Experience presenting to senior leadership
- Experience working successfully in a matrix environment
- Flexible, dynamic personality who works well in a team environment.
- Willing and able to travel up to 20% of the time
Preferred Qualifications
- Master's degree in business and/or related field
- JD degree
- Experience with data extraction and analysis technologies
- Experience with reporting and creating metrics for management
Additional Information
This role is "remote/work at home" and can be based anywhere in the contiguous United States with the ability to travel up to 20% of the time.
Work at Home 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.
Scheduled Weekly Hours
40Pay 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.
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: 10-06-2025
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.
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.