Provider Engagement Professional

CenterWell; United States; Remote; USD 59,000 - 81,000; Full time

Job summary

CenterWell Senior Primary Care seeks a Provider Engagement Professional to develop long-term relationships with physicians, providers and health systems to support financial and quality performance under the contracted health plan. You will interpret data and determine actions with independence.

This remote role reports to the Director, Provider Engagement and requires travel to provider offices about 3–4 days per week, maintaining a 40-hour work week.

Qualifications

• Bachelor’s degree required; Master’s degree preferred.
• 1–5 years in health care or managed care with Provider Contracting, Network Management or Provider Relations experience.
• Experience working with service fund reports and reimbursement/bonus methodologies.
• Ability to manage multiple projects and meet deadlines; strong communication skills.

Responsibilities

• Develop and grow positive relationships with physicians, providers and health systems.
• Support and improve financial and quality performance within the contracted relationship.
• Represent provider engagement across financial, quality, data sharing and clinical management areas.
• Travel to provider offices 3–4 days per week; remote work from home office.

Skills

Project management

Data interpretation

Effective communication

Independent decision making

Education

Bachelor’s Degree

Master’s Degree

Job description

Become a part of our caring community

The Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. You will work assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action. You will report to the Director, Provider Engagement.

You will represent 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.

Use your skills to make an impact

Required Qualifications:

• Bachelor’s Degree.
• 1-5 years of health care or managed care with Provider Contracting, Network Management or Provider Relations experience.
• Experience working with service fund reports.
• Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Demonstrated ability to manage multiple projects and meet deadlines.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• This is a remote position working out of your home office that will include travel to provider offices approximately 3-4 days/week.

Preferred Qualifications:

• Master’s 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.

#LI-CM1

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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.

$59,300 - $80,900 per year

This 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer atCenterWell.com.

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.