Sr. Program Delivery Professional

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members, or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional's work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Provider Reconciliation Program (PRP) is committed to delivering comprehensive and accurate reconciliation of claims data to uphold the highest standards of data integrity and drive positive member outcomes. By partnering closely with providers, we proactively work to decrease claim outages and increase the volume of organic claim submissions, ensuring a seamless experience for both providers and members. The robust data we capture directly supports closure of HCC and Stars gaps, advancing quality, compliance, and organizational performance.

The Senior Program Delivery Professional develops programs designed to drive value-based relationships. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Use your skills to make an impact.

Required Qualifications

• Bachelor's degree or equivalent experience
• Ability to interpret complex data sets and provide actionable insights
• Strong knowledge of Microsoft Office products (Word, Excel, Access)
• Demonstrated ability to articulate ideas effectively in both written and oral forms, and is able to facilitate provider meetings with confidence, enthusiasm, and a teaching mindset
• Demonstrated experience building and maintaining provider relationships, including addressing concerns in a timely and effective manner
• Proven skill in handling competing priorities while staying organized and focused, demonstrating the ability to work independently and seek guidance when appropriate
• Proven passion about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• CPC (Certified Professional Coder) Certification
• Proficiency in data analysis tools and platforms (e.g., SQL, Power BI)
• Demonstrated expertise in working collaboratively on IT projects
• Demonstrated ability to communicate technical information clearly to non-technical stakeholders
• Demonstrated experience with anticipating future needs, building and sustaining pipelines to support long-term growth, and aligning initiatives with organizational strategies
• Experience facilitating educational meetings and developing provider-facing educational materials to support knowledge sharing and engagement

Additional Information

Benefits 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