Provider Engagement Executive
HumanaAbout the role
Become a part of our caring community and help us put health first
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.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
- Bachelor's Degree or 6+ years of equivalent experience in managed care.
- 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
- Ability to travel as needed within Oklahoma
- 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
- Schedule: Monday through Friday, 8:00 AM – 5:00 PM Eastern Time
- Work Location: Oklahoma
- Work Style: Remote, OK
- Travel Requirements: Up to 30% travel for provider visits, with occasional visits to the Oklahoma City Office.
Work-at-Home (WAH) Internet Statement
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 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.
Interview Format
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.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.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.
De
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