Humana

About Humana

 

Job Category:

Member Quality & Financials - Risk Adjustment & STARS operations

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full Time

Market Consultation/Partnership Professional 2

Humana - Kmg Irvine, California

Posted: 10/14/2018

Description

The Market Consultation/Partnership Professional 2 promotes and improves the quality and measurement of care delivery programs with a market(s). The Market Consultation/Partnership Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Market Consultation/Partnership Professional 2 engages and partners with physicians, physician groups, and market leadership to drive initiatives. Influences and consults on matters related to quality and measurement of care delivery programs with a market(s). Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

               

Required Qualifications

  • Bachelor’s Degree in Business, Finance, Healthcare or a related field
  • Medicare experience related to value based provider agreements
  • Prior longevity in a claims processing and/or billing
  • Comprehensive knowledge in Risk Adjustment
  • Proficiency with Microsoft Office
  • Experience with Claims Administration System, Electronic Medical Records (EMR), or Practice Management Systems.

Preferred Qualifications

  • Master’s Degree in Business Administration or a related field
  • Prior group implementation and/or project management experience
  • SQL

Scheduled Weekly Hours

40

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