Humana Director Contracting and Operations - Ohio in Cincinnati, Ohio

Role: Contracting and Operations Director Assignment: National Contracting Location: Cincinnati, OH

We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our providers, consumers, employers, agents and others we work with. At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our providers, members, employers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.

Assignment Capsule The Contracting and Operations Director will lead and manage the development of Humana’s overall provider relationships within a geographic region. Drive strategic initiatives within the provider network and ensure that the alignment of departmental objectives is congruent with the overall business strategy.

  • Lead Provider Contracting within a region, Commercial, Medicare Advantage and Medicaid

  • Initiate and maintain productive long-term relationships with provider representatives, subscribers, hospitals, account managers and internal sales teams

  • Provide effective operations management, ensuring that all contracts are within required guidelines and financial parameters, and maintain current provider data within payment systems

  • Apply economic and strategic planning models to all endeavors in your region in order to align business, process, and operational principles with area-specific goals Key Competencies

  • Business and Financial Acumen, Acts Strategically, Collaborates, Lead Positively, strong work ethic, Operations , Human capital/management experience, understanding the technical aspects of contract operationalization

    Role Essentials

  • Bachelor’s Degree in Business, Finance or a related field; or a minimum of 10 years’ provider contracting experience to include hospital contracting

  • A minimum of 5 years’ progressive contracting experience for a national health plan

  • Solid leadership/management experience including supervisory and teambuilding

  • Strong financial acumen with proficiency in analyzing and interpreting financial trends in the provider contracting arena

  • Proven contract preparation and negotiation skills, with an in-depth knowledge of Medicare, Commercial and Medicaid and other reimbursement methodologies Role Desirables

  • Master’s Degree in Business Administration or Finance

  • Experience with ACO/Risk Contracting

  • Value based contracting experience

    Reporting Relationships

    This position reports to a Regional Vice President–Provider Experience

Title: Director Contracting and Operations - Ohio

Location: OH-Springdale

Other Locations: US-OH-Cincinnati, US-OH-Columbus, US-Ohio

Requisition ID: 191937

Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.