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Humana Director of LTSS Provider Contracting in Lancaster, South Carolina

Description

The Director, Provider Contracting initiates, negotiates, and executes physician, hospital, and/or other provider contracts and agreements for an organization that provides health insurance. The Director, Provider Contracting requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

Responsibilities

This Director, Provider Contracting will be a national support role for Long Term Services and Support (LTSS). This individual will take the lead on LTSS support and strategy, including the path to value.

In this role, the Director 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.

Required Qualifications

  • Bachelor's Degree

  • Experience in managing community based LTSS programs

  • Experience in value based and path to value contracting.

  • Strong leadership experience with the ability to manage provider engagement associates that are market-based

  • Contributor to business development and RFP strategies

  • Proven contract preparation skills, with an 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 be passionate about contributing to an organization focused on continuously improving consumer experiences

Scheduled Weekly Hours

40

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