Provider Engagement Executive

Position Overview

Become a part of our caring community and help us put health first. The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Executive is the relationship quarterback for a multi-disciplinary team assigned to value-based partners. This team consults and drives results leading to improved patient outcomes.

The Provider Engagement Executive represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation, and coding, HEDIS and STARs performance, operational improvements, and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.

Use your skills to make an impact.

Requirements

• Required Qualifications:

  • Bachelor's Degree
  • 5 or more years of health care or managed care related experience - Network Performance Management, Population Health, or Provider Relations
  • 2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
  • Experience with value-based care, population health, or other healthcare performance improvement
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
  • Demonstrated ability to manage multiple projects and meet deadlines
  • Comprehensive knowledge of all Microsoft Office applications
  • Ability to travel as needed

• Preferred Qualifications:

  • Master's Degree
  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance
  • Comprehensive knowledge of Medicare policies, processes, and procedures

Responsibilities

• Develop and grow positive, long-term relationships with physicians, providers, and healthcare systems.
• Support and improve financial and quality performance within the contracted working relationship with the health plan.
• Act as the relationship quarterback for a multi-disciplinary team assigned to value-based partners.
• Consult and drive results leading to improved patient outcomes.
• Represent the scope of health plan/provider relationship across various areas including financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation, and coding, HEDIS and STARs performance, operational improvements, and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.
• Advise executives to develop functional strategies on matters of significance.
• Exercise independent judgment and decision making on complex issues.

Employment Type

• Full time

Location Type

• [Information not provided]

Salary

• [Information not provided]

Company Information

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Work At Home / Internet Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Information

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file.