Senior Provider Engagement Professional

Senior Provider Engagement Professional

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The Senior Provider Engagement Professional 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. This role involves moderately complex to complex issues requiring in-depth evaluation of variable factors.

The Senior Provider Engagement Professional represents the scope of health plan/provider relationships across various areas, including:

• Financial performance
• Incentive programs
• Quality and clinical management
• Population health
• Data sharing and connectivity
• Documentation and coding
• HEDIS and STARs performance
• Operational improvements
• Provider performance, member experience, market growth, provider experience, and operational excellence.

This position begins to influence department strategy and involves making decisions on moderately complex to complex issues regarding technical approaches for project components, with work performed without direction. The role exercises considerable latitude in determining objectives and approaches to assignments.

Requirements

• Bachelor's Degree
• Must reside in Ohio
• 5 or more years of Health care or managed care experience with Provider Contracting, Network Management, or Provider Relations
• Proven planning, preparation, and presenting skills
• Established knowledge of reimbursement and bonus methodologies
• Demonstrated ability to manage multiple projects and meet deadlines
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

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

Additional Information

• Interview Technology: As part of our hiring process, we will be using interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
• Internet Service Requirements (for Remote/Hybrid roles):
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps.
  • Wireless, wired cable, or DSL connection is suggested.
  • Satellite, cellular, and microwave connections may be used only if approved by leadership.
  • Employees in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Equipment: Humana will provide appropriate telephone equipment for Home or Hybrid Home/Office employees.
• Work Environment: Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Compensation

• Scheduled Weekly Hours: 40
• Pay Range: $71,100 - $97,800 per year (This is a good faith estimate of starting base pay. Actual pay will vary based on location, skills, knowledge, experience, education, and certifications.)
• Bonus Incentive: This job is eligible for a bonus incentive plan based on company and/or individual performance.

Company Information

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”)