Become a part of our caring community and help us put health first
 

The Director, Provider Engagement develops and grows positive, long-term relationships with physicians, providers, and healthcare systems. These relationships intend to support financial and quality performance within the contracted working relationship with the health plan. The Director, Provider Engagement requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

You will:

• Lead strategic relationships between the health plan and providers, focusing on financial performance, incentive programs, quality improvement, clinical management, and population health programs.
• Oversee and guide enhancements in data sharing, connectivity, documentation, coding accuracy, HEDIS and STARs performance, and operational processes to improve provider outcomes and member experience.
• Implement new or updated programs and large-scale projects, ensuring understanding of technical and operational procedures for execution.
• Develop strategic plans to support market growth, provider satisfaction.
• Provide informed input into functional strategy, contributing to organizational goals and performance improvement.
• Collaborate with all partners to foster provider engagement and deliver measurable improvements across all main performance areas.

Use your skills to make an impact
 

Required Qualifications

• Master's degree from an accredited institution.
• Minimum of 8 years of experience in provider contracting or a related field.
• At least 5 years of proven management experience, demonstrating leadership and team development skills.
• 5 years of direct experience working with Louisiana Medicaid programs, including familiarity with relevant policies and regulations.
• Demonstrated relationship-building skills, with a proven ability to establish and strengthen partnerships with providers and stakeholders through effective verbal and written communication of complex information.
• Demonstrated ability to proficiently utilize Microsoft Office applications—including Word, Excel, PowerPoint, Teams, and Outlook—for preparing reports, conducting analyses, and delivering effective presentations.
• Willingness to travel up to 25% of the time to meet our needs.
• Residency within the state of Louisiana is mandatory.

Preferred Qualifications

• Prior work experience in the health solutions industry with demonstrated success directing and leading teams
• Proficiency in quality improvement processes, analyzing and interpreting financial trends

Driving Statement

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher

Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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 required.
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates 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 associates 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

Workstyle: Combination remote work at home and onsite/provider office/conferences

Hours: We require you to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, with flexibility for business needs.

Travel: Requires 25% travel within Louisiana to the Market office, Providers office and Provider conferences

Additional Information

Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two