About Humana


Job Category:

Market Strategy - Engagement


United States

Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Engagement Executive-WAH in Tri-Cities, TN

Humana - Work At Home, Tennessee

Posted: 11/14/2018


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.


Required Qualifications
•    High school diploma or equivalent
•    5+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
•    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 Tri-cities area and surrounding counties 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
Additional Information
Interview Format 

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice 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. 
If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. 

Scheduled Weekly Hours


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