Provider Engagement Executive
Remote US
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 to our 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
Required Qualifications
5 or more years of health care or managed care
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
Advanced organizational skills and/or project management
Ability to travel as needed
Must be able to travel approximately 20% within the assigned Region (Texas, Oklahoma, and Arkansas)
Preferred Qualifications
Bachelor's Degree, Nursing Degree, or higher
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
As part of our hiring process for this opportunity, we will be using an 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.
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 recommended; 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
If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Home office setup required Illinois Montana Must travel 20% Remote US South Dakota Specific internet requirements Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota
Benefits/Perks401k retirement 401k Retirement Savings Bonus Incentive Bonus incentive plan Caring community Competitive benefits Dental Disability Flexible work environment Holidays Internet expense reimbursement Life Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Smart healthcare decisions Support whole-person well-being Telephone equipment provided Time off Vision Vision Benefits Volunteer time Volunteer time off Work From Home
Tasks- Advise executives
- Analysis
- Analyze data
- Decision making
- Develop functional strategies
- Develop relationships
- Documentation
- Manage multiple projects
- Manage projects
- Operational improvements
- Planning
- Project management
- Research
- Support financial performance
- Training
Administrative Analysis Analyzing BI Business Clinical Coding Compensation Data Data Sharing Decision making Dental Documentation Financial Performance Functional strategies Health care Healthcare Healthcare services Healthcare systems HEDIS HIPAA Insurance IT Leadership Life Insurance Managed Care Management Medicaid Medicare Microsoft Microsoft Office Microsoft Office Applications Nursing Operational Excellence Operational Improvements Organizational Performance Improvement Planning Policy Population health Project Management Provider engagement Recruitment Reimbursement methodologies Research STARS Stars performance Technology Training Travel Value-based care Vision Wellness
Experience5 years
EducationAssociate Bachelor's Bachelor's degree Business Education Healthcare Higher Higher Degree IT Management Nursing Nursing Degree
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9