Senior Provider Network Manager
Maven ClinicFull Time
Senior (5 to 8 years)
Candidates must possess a minimum of three years of experience in provider relations, engagement, communications, and/or health plan operations. A minimum of three years of experience with value-based contracting strategy/analysis and two years of process creation or improvement experience are also required. The role demands strategic thinking, strong problem-solving abilities, excellent interpersonal, organizational, written, and oral communication skills, and proficiency in MS Office applications including SharePoint, Teams, Word, PowerPoint, Outlook, and Excel. A Bachelor's or Master's degree and familiarity with SC Medicaid/government healthcare are preferred.
The Market Development Advisor will provide support for Medicaid product implementation, operations, contract compliance, and federal contract applications. Key duties include advising on Provider Relations and Network Operations performance, driving network strategic initiatives, establishing infrastructure to measure KPIs, developing and managing the Provider Support Plan and state reporting, and overseeing provider communications and training. The advisor will also monitor performance against contractual commitments, perform root cause analysis for data inaccuracies, and facilitate workgroup calls to improve data accuracy and network strategy.
Health insurance provider for seniors and military
Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.