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Provider Contracting Jobs (NOW HIRING)

Humana

Provider Contracting Executive

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and ...

Humana

Provider Contracting Executive

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and ...

Humana

Provider Contracting Executive

OR · On-site +1

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and ...

Humana

Provider Contracting Executive

OR · On-site +1

The Provider Contracting Executive communicates contract terms, payment structures, and reimbursement rates to providers. Analyzes financial impact of contracts and terms. Maintains contracts and ...

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Provider Contracting information

What is provider contracting?

Provider contracting is the process by which healthcare organizations, such as insurance companies or health plans, establish agreements with medical providers, such as hospitals, physicians, and clinics. These contracts outline the terms of service, payment rates, and responsibilities for both parties. The goal is to ensure that patients have access to a network of qualified providers at agreed-upon costs, while providers receive timely and consistent reimbursement for their services.

What are the key skills and qualifications needed to thrive as a provider contracting specialist?

To thrive as a Provider Contracting Specialist, you need strong negotiation skills, analytical abilities, and a background in healthcare administration or business, often supported by a bachelor's degree. Familiarity with contract management software, claims processing systems, and regulatory compliance tools is typically required. Exceptional communication, relationship-building, and attention to detail are vital soft skills for success in this role. These competencies ensure effective contract negotiations, compliance with regulations, and the development of strong provider networks that benefit both patients and organizations.

What are some common challenges faced in a provider contracting role, and how can they be managed effectively?

Professionals in Provider Contracting often encounter challenges such as negotiating mutually beneficial agreements, keeping up with evolving healthcare regulations, and balancing provider expectations with organizational goals. Effective management of these challenges requires strong communication and negotiation skills, as well as staying current on industry trends and compliance requirements. Building collaborative relationships with providers and internal teams, maintaining clear documentation, and leveraging data analytics can help streamline the contracting process and achieve successful outcomes.

What is the difference between Provider Contracting vs Provider Relations Specialist?

AspectProvider ContractingProvider Relations Specialist
Primary FocusNegotiating and managing provider contractsBuilding and maintaining provider relationships
ResponsibilitiesContract negotiations, rate setting, complianceProvider communication, issue resolution, outreach
Required SkillsNegotiation, understanding of contracts, industry regulationsCommunication, customer service, relationship management
Work EnvironmentOffice-based, healthcare organizations, insurance companies

Provider Contracting focuses on negotiating and managing provider agreements, ensuring compliance and optimal rates. In contrast, Provider Relations Specialists prioritize maintaining strong provider relationships, addressing concerns, and facilitating communication. Both roles are essential in healthcare administration but serve different functions within the provider network.

More about Provider Contracting jobs

What cities are hiring for Provider Contracting jobs?

Cities with the most Provider Contracting job openings:

What are the most commonly searched types of Provider Contracting jobs?

The most popular types of Provider Contracting jobs are:

What states have the most Provider Contracting jobs?

States with the most job openings for Provider Contracting jobs include:

Provider Contracting jobs near you
Infographic showing various Provider Contracting job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 76% Full Time, 15% Part Time, and 6% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution.

Provider Contracting Specialist

Prime Health Services

Franklin, TN • On-site

Full-time

Re-posted 6 days ago

Job description

Job Type
Full-time
Description
Provider Contracting Specialist (Healthcare Network Development)
Location: Franklin, TN (In-Office)
We're seeking a Provider Contracting Specialist to help expand and strengthen our national healthcare network. In this role, you will identify, recruit, and negotiate agreements with physicians, provider groups, and ancillary facilities to join our PPO network.
This position is ideal for someone who enjoys relationship-building, negotiation, and working in a fast-paced healthcare environment with measurable goals.
What You'll Do
  • Recruit and onboard healthcare providers (physicians, facilities, ancillary providers) into the PPO network
  • Negotiate reimbursement rates and contract terms aligned with company and regulatory guidelines
  • Manage contracting activities within assigned geographic regions
  • Build and maintain strong relationships with provider offices and group administrators
  • Support network expansion initiatives, including specialty networks and client-specific projects
  • Analyze proposed reimbursement rates to ensure alignment with internal guidelines
  • Track progress and maintain accurate records in internal systems
  • Participate in outreach campaigns via phone, email, and targeted initiatives
  • Resolve provider contract issues and escalate as needed
  • Collaborate with internal stakeholders to execute contracts efficiently

Requirements
What We're Looking For
  • Bachelor's degree in Business, Healthcare Administration, Communications, or a related field (or equivalent experience)
  • 1+ year of experience in healthcare, managed care, or provider contracting
  • Strong communication and negotiation skills
  • Ability to manage multiple priorities in a deadline-driven environment
  • Analytical mindset with attention to detail
  • Proficiency with Microsoft Office tools (Excel, Word, Outlook)
  • Self-motivated, adaptable, and comfortable working with performance goals and metrics

What Sets You Apart
  • Experience with provider network development or payer contracting
  • Familiarity with workers' compensation, group health, or liability networks
  • Background in healthcare sales, recruiting, or provider relations

Why Join Us
  • Opportunity to play a direct role in expanding a national healthcare network
  • Exposure to contract negotiation and healthcare economics
  • Clear path for growth into Network Development or Contracting Leadership roles
  • Collaborative, team-oriented environment
  • Competitive compensation with performance expectations

Work Environment
  • Office-based role with occasional travel for provider meetings as needed
  • Fast-paced, goal-oriented team environment

About Prime Health Services
Since 2001, Prime Health Services (PHS) has been a leader in medical cost containment and provider network development. Our nationwide PPO Network supports insurance carriers, TPAs, self-insured employers, and government entities with tailored, tech-driven solutions that deliver quality healthcare at discounted rates.

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