1+ months

Provider Engagement Executive

Humana
Phoenix, AZ 85067
Description The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial. Responsibilities 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. Required Qualifications + Bachelor's Degree + 6+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience + 2+ years of demonstrated project management experience and partnering with senior leadership on strategic initiatives + 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 + Valid driver's license with reliable transportation and the ability to travel within the region up to 30% of the time with occasional travel outside the region Preferred Qualifications + Masters Degree + Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance + Understanding of Medicare Stars/HEDIS measures and risk adjustment documentation + Comprehensive knowledge of Medicare policies, processes and procedures Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2020-02-21 Expires: 2020-04-22

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Provider Engagement Executive

Humana
Phoenix, AZ 85067

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