Manager, Network Performance

Humana Inc; Virginia (MN); Remote; USD 94,000 - 131,000; Full time

Job summary

Humana Inc. seeks a Manager of Network Performance to lead a team focused on enhancing provider engagement and Stars ratings. This role requires expertise in healthcare provider relations, team leadership, and strategic performance improvement initiatives. The successful candidate will drive operational success and foster a collaborative work environment while enjoying a comprehensive benefits package from day one, including medical, dental, vision, and generous paid time off.

Benefits

Medical Benefits

Dental Benefits

Vision Benefits

Health Savings Accounts

401(k)

PTO including paid holidays and parental leave

Qualifications

• 2+ years Medicare experience with value-based care.
• Knowledge of HEDIS/Stars and CMS quality measures.
• Strong analytical and presentation skills.

Responsibilities

• Lead a team to improve provider performance.
• Analyze healthcare data for operational decisions.
• Collaborate with multiple departments for performance enhancements.

Skills

Leadership

Communication

Analytical Skills

Coaching

Process Improvement

Education

Bachelor’s Degree in Business, Finance, Healthcare, or related field

Tools

Microsoft Office

Job description

Become a part of our caring community and help us put health first

As the Manager of Network Performance, you will lead a team of Network Performance Professionals dedicated to improving provider performance and enhancing Stars ratings. Your role is pivotal in fostering a collaborative and supportive environment where your team can thrive. By building and maintaining strong relationships with assigned physician groups, your team will implement strategies and tactics that elevate network performance.

This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will be responsible for guiding, mentoring, and developing your team to achieve their full potential, ensuring that they are equipped with the knowledge and tools necessary to excel in their roles.

• Leads a team of up 11 provider-facing direct reports, guiding them in their efforts to improve provider performance
• Serves as the expert on CMS Stars program, HEDIS, CAHPS, and HOS, providing guidance and support to the team
• Builds and maintains strong relationships with provider practices, leading the team's discussions to find and implement improvement opportunities, develop workflows, and monitor outcomes while focusing on solutions that enhance provider engagement
• Informs and leads the team based on enterprise, regional, and departmental KPIs and OKRs, ensuring alignment with organizational goals and objectives
• Partners with other departments to advance performance in Provider Engagement, Stars Improvement, MRA, Interoperability, Clinical, Corporate Partners, and Provider Contracting to improve provider/member engagement. Leads interdepartmental and team strategy meetings
• Ingests data from various sources, analyze it, and informs the team and leadership of learnings
• Creates data-supported, focused education to drive team tactics and improve performance
• Directs the team's focus toward solutions that maximize provider abilities to engage effectively
• Owns decisions related to people leadership, resources, strategic planning, and tactical operations for the team
• Reviews and communicates performance results of the team and initiatives
• Articulates and models desired culture attributes, actively supporting team engagement, performance, well-being improvement plans, and team activities

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
• And more

Use your skills to make an impact

Required Qualifications

• 2+ years Medicare experience and understanding of value-based care model
• Knowledge of HEDIS/Stars and CMS quality measures
• Proficiency in analyzing and interpreting healthcare data and trends
• Demonstrated capability with leading, coaching, and developing associates formally or informally (training, SME, etc.)
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint
• Strong communication and presentation skills, both verbal and written, with experience presenting to internal and external customers, including high-level leadership
• Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care

Preferred Qualifications

• Bachelor’s Degree in Business, Finance, Healthcare, or a related field
• Progressive management experience, leading and developing others
• Progressive experience in the health solutions industry, particularly with interoperability
• Prior managed care or Medicaid experience
• Background working in quality improvements

Work at Home/Remote Requirements

Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
  • Wireless, Wired Cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
  • Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Our Hiring Process

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor.This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Ifyou have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

#LI-LM1

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$94,900 - $130,500 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.