Humana

About Humana

 

Job Category:

Market Strategy - Engagement

Country:

United States

Postal Code:

06758

Approximate Salary:

Not Specified

Position Type:

Full time

Provider Engagement Executive

Humana - Lakeside

Posted: 07/4/2018

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
  • 5+ 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 
  • Experience and understanding of Managed Care
  • Strategic thinking and planning capabilities; organized and detail-oriented
  • Excellent written and verbal communication skills
  • Excellent relationship building skills with both internal and external partners
  • Willingness to manage and prioritize diverse projects
  • Business and financial acumen in the health care field
  • Reliable transportation with the ability to travel within the region up to 75% of the time

Preferred Qualifications

  • Bachelor's degree preferred
  • Understanding of managed care reimbursement methodologies
  • 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

Scheduled Weekly Hours

40

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