Associate Director, Provider Engagement — Value-Based Care

Humana; Illinois; On-site; USD 115,000 - 158,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Disability insurance

Life insurance

Job summary

Humana seeks an Associate Director, Provider Engagement in Illinois to lead a team focused on growing positive relationships with contracted providers and driving high-quality, high-value care for Humana members.

You will bring content expertise in value-based contracting, performance improvement, and HEDIS, shaping policies and procedures and collaborating with internal partners to enhance provider performance and network value.

Qualifications

• Must reside in Illinois and hold a Bachelor's degree.
• Experience with the Illinois Medicaid MCO contract, including value-based payment and quality improvement standards.
• 6+ years of progressive experience in managed care operations, including value-based payment, provider performance improvement and quality.
• Proficiency in analyzing and interpreting financial trends for health care costs, admin expenses, and quality/bonus performance.
• Proficiency in quality improvement principles and analyzing quality metrics (e.g., HEDIS).
• Experience with Medicaid policies, contracts, and provider types (pediatrics, OB/GYN, behavioral health).
• Strong relationship management skills and leadership experience coordinating with senior leadership.

Responsibilities

• Establish policies and operating procedures for a team of provider engagement representatives.
• Guide engagement strategy to support high performance in quality measures and value-based payment models.
• Develop and execute provider outreach campaigns related to quality metrics and value-based care.
• Monitor feedback from providers to inform process improvements.
• Track team performance against KPIs and contractual commitments; collaborate with health plan leadership as needed.
• Represent local market planning and strategy with internal partners for cross-department alignment.
• Work with internal partners to increase provider network participation in value-based arrangements.
• Onboard and train new provider engagement team members.

Skills

Leadership

Strategic thinking

Relationship management

Data analysis

Travel readiness

Education

Bachelor's degree

Tools

Quality improvement tools

Job description

Humana seeks an Associate Director, Provider Engagement in Illinois to lead a team focused on growing positive relationships with contracted providers and driving high-quality, high-value care for Humana members.

You will bring content expertise in value-based contracting, performance improvement, and HEDIS, shaping policies and procedures and collaborating with internal partners to enhance provider performance and network value.