Humana

About Humana

 

Job Category:

Market Strategy - Engagement

Country:

United States

Approximate Salary:

Not Specified

Position Type:

Full time

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Provider Education Relations Professional 2 - North Chicago

Humana - Work At Home, Illinois

Posted: 08/3/2018

Description

The Provider Engagement Professional 2 will need to travel to James A Lovell FHCC military facility. The preferred candidate will reside in either Northern Chicago or Northern Indiana area. This job 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 Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Provider Engagement Professional 2 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. 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
  • 1-5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies 
  • Demonstrated ability to manage multiple projects and meet deadlines

Preferred Qualifications

  • Masters 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

  • Position will be responsible for James A Lovell FHCC. 
  • Preferred candidate will reside in Northern Chicago or Northern Indiana

Scheduled Weekly Hours

40

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