Humana

About Humana

 

Job Category:

Market Strategy - Engagement

Country:

United States

Postal Code:

40201

Approximate Salary:

Not Specified

Position Type:

Full Time

Provider Engagement Professional 2-Louisville, KY

Humana - Louisville, Kentucky

Posted: 09/15/2018

Description

The Provider Engagement Professional 2 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
•    1-5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
•    High school diploma or equivalent
•    Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies 
•    Demonstrated ability to manage multiple projects and meet deadlines
•    Proficient in MS Office
•    Basic understanding of Hospital/Physician claims processing, contracts, member benefits, etc.


Preferred Qualifications
•    Bachelors/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
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

40

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