Provider Engagement Director, Value-Based Care (Remote)

Humana; Illinois; Remote; USD 115,000 - 158,000; Full time

Benefits offered by this job

Driver safety program

Remote work option

Job summary

Humana is seeking an Associate Director, Provider Engagement to lead a team in growing high-quality, value-based care relationships with Medicaid providers in Illinois. You will drive performance, develop strategies with stakeholders, and ensure compliance with contracts and quality initiatives.

The role requires extensive leadership in provider networks, proficiency with Medicaid policies, and the ability to work remotely with periodic travel to Humana offices in Illinois for training and

Qualifications

• Must reside in Illinois.
• Experience with Medicaid MCO contracts, value-based payment, and quality improvement.
• 6+ years in managed care operations, including value-based payment and quality.
• Ability to analyze financial trends in healthcare costs and quality performance.
• Strong knowledge of Medicaid policies, contracts, and provider types.
• Willingness to travel within Illinois.

Responsibilities

• Establish policies and procedures for Provider Engagement team.
• Guide engagement strategy to improve quality measures and value-based payments.
• Develop provider outreach campaigns related to quality metrics and value-based models.
• Monitor provider performance and provide feedback to improve processes.
• Collaborate with health plan leadership for cross-department alignment.
• Onboard and develop new Provider Engagement staff.

Skills

Relationship management

Leadership

Strategic mindset

Problem solving

Education

Bachelor's degree

Master's Degree

Clinical Degree (RN, APRN, PA)

Job description

Humana is seeking an Associate Director, Provider Engagement to lead a team in growing high-quality, value-based care relationships with Medicaid providers in Illinois. You will drive performance, develop strategies with stakeholders, and ensure compliance with contracts and quality initiatives.

The role requires extensive leadership in provider networks, proficiency with Medicaid policies, and the ability to work remotely with periodic travel to Humana offices in Illinois for training and