Vice President, Provider Contracting

Overview

Join our dedicated team and help us prioritize health!

The Vice President of Home Health Provider Contracting will spearhead a dynamic team focused on negotiating and managing reimbursement agreements with managed care organizations and various health plans, including Commercial, Medicare Advantage, and Medicaid. This leader will set ambitious payment targets, craft effective payer strategies, and implement key contracting principles while advancing towards value-based care and innovative payment models, such as shared savings and pay-for-performance.

Experience in payer or managed care contracting is essential, and while home health or post-acute experience is a bonus, it is not required.

• Lead end-to-end payer negotiations for home health services by developing strategic plans, serving as the chief negotiator, and securing advantageous rates across various contracts.
• Define annual payment targets and contracting strategies, including pricing and volume goals, prioritizing payer opportunities, and establishing multi-year roadmaps for growth.
• Manage financial analytics; oversee modeling, valuation, and scenario analyses to inform deal-making and renewals.
• Advance innovative contracting models, ensuring alignment with value-based care initiatives tailored for home health services.
• Build robust relationships with payers and ensure multi-payer coordination by collaborating on quality measures and improving overall health equity standards.
• Translate contractual agreements into operational practices by partnering with Revenue Cycle, Finance, and other departments to monitor payer performance and resolve any disputes.
• Collaborate closely with Compliance and Legal teams to manage all aspects of payer agreements, ensuring timely execution and adherence to regulatory standards.
• Cultivate a strong internal contracting process to ensure timely execution of documents and facilitate any necessary amendments.
• Oversee metrics that track payer performance, including rates, denials, and overall portfolio results, ensuring comprehensive reporting on key performance indicators.
• Mentor and develop team members, fostering a culture of transparency, collaboration, and high-performance standards.
• Ensure strict compliance with all contract terms and risk management protocols, coordinating with legal for contract language and regulatory updates.

Center Well, part of Humana, is committed to enhancing the health of our communities through a patient-centered approach. As the largest provider of senior-focused primary care and significant home health services, we prioritize the physical, emotional, and social wellness of our patients. We offer a supportive and dynamic work environment with opportunities for personal and professional growth.

• Required:
  
  7+ years in payer or managed care contracting with direct negotiation experience; leadership skills managing a contracting team.
• Preferred:
  Experience in home health or post-acute services within a multi-market organization.
• Strong background in value-based care and hands-on implementation of alternative payment models.
• Exceptional financial acumen and expertise in contract valuation and risk modeling.
• Strong relationship-building and influencing skills with internal and external stakeholders.
• Ability to translate performance data into actionable insights for leadership.
• Bachelor's degree required;
  Master's degree preferred (MBA/MHA).
• Travel may be required occasionally, as this position is remote but may involve trips to Humana's offices for meetings or training.

The estimated compensation for this position ranges from $184,800 to $254,100 per year, depending on location and individual qualifications.

Center Well offers comprehensive benefits including medical, dental, vision, a 401(k) retirement plan, generous paid time off, and other well-being resources. We are an equal opportunity employer committed to a diverse and inclusive workplace.