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Virtual Health Contracting Advisor - Job Opportunity at Humana

Remote, US
Full-time
Senior
Posted: March 5, 2025
Remote
USD 115,200 - 158,400 per year

Benefits

Comprehensive Healthcare Suite: Premium medical, dental, and vision coverage from day one
Financial Security Package: Strong 401(k) plan with company match
Work-Life Integration: Flexible remote work with home office support
Professional Development: Tuition assistance and career advancement programs
Family Support: Paid parental and caregiver leave
Wellness Focus: Comprehensive insurance package including life and disability
Time Off Benefits: PTO, holidays, and volunteer time

Key Responsibilities

Lead strategic virtual care provider partnerships for Medicaid programs
Design and implement innovative payment models and performance metrics
Drive contract negotiations and relationship management with healthcare providers
Ensure regulatory compliance and risk management in virtual care agreements
Coordinate cross-market virtual care solutions deployment
Develop and execute network expansion strategies

Requirements

Education

Bachelor's degree required, Master's preferred in business administration, healthcare administration, public administration, public health, or public policy

Experience

5+ years in network development, contracting, and/or network operations; 2+ years of project leadership; 2+ years of Medicaid experience

Required Skills

Contract negotiation expertise Contract language development Contract administration Interpersonal communication Organizational skills Presentation abilities Analytical thinking Strategic planning Healthcare industry knowledge
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Sauge AI Market Intelligence

Industry Trends

Virtual healthcare delivery is experiencing rapid expansion in Medicaid programs, driven by accessibility needs and technological advancement Value-based care models are increasingly being integrated into virtual care arrangements State-specific regulatory frameworks are evolving to accommodate telehealth expansion

Salary Evaluation

The offered salary range of $115,200-$158,400 is competitive for senior healthcare contracting roles, reflecting the specialized nature of virtual health and Medicaid expertise

Role Significance

Typically works within a matrix organization, collaborating with legal, finance, and operational teams of 10-15 people
Senior strategic position with significant influence on virtual care implementation and market expansion

Key Projects

Virtual care network expansion initiatives Payment model innovation programs Provider partnership launches Regulatory compliance frameworks

Success Factors

Deep understanding of Medicaid regulations and virtual care dynamics Strong negotiation and relationship management capabilities Ability to balance provider partnerships with organizational objectives Strategic thinking with operational execution skills

Market Demand

High demand position due to increasing focus on virtual care solutions and Medicaid expansion across states

Important Skills

Critical Skills

Virtual care market knowledge: Essential for evaluating partnership opportunities and market trends Contract negotiation expertise: Critical for securing favorable terms and managing provider relationships Strategic planning: Vital for market expansion and program development

Beneficial Skills

Healthcare technology understanding Project management capabilities Policy analysis skills

Unique Aspects

Role combines traditional network development with emerging virtual care models
Position influences both strategic direction and operational execution
Opportunity to shape future of virtual care in Medicaid space

Career Growth

2-4 years in role before advancement, depending on market expansion success and strategic impact

Potential Next Roles

Director of Network Strategy Head of Virtual Care Operations Senior Director of Provider Partnerships VP of Network Development

Company Overview

Humana

Humana is a leading healthcare company with significant presence in Medicare, Medicaid, and commercial insurance markets

Major player in healthcare insurance and services, particularly strong in Medicare Advantage market
National footprint with growing Medicaid presence across multiple states
Innovation-focused environment with emphasis on work-life balance and remote work flexibility
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