Provider Engagement Professional

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

Job summary

Join a forward-thinking organization dedicated to improving healthcare outcomes. As a Provider Engagement Professional, you will foster long-term relationships with healthcare providers, enhancing financial and quality performance. This role offers the opportunity to work remotely while collaborating with a dynamic team. You will utilize your expertise in healthcare provider contracting and excel in managing multiple projects. With a commitment to health and well-being, this position allows you to make a significant impact in the community while enjoying competitive benefits and a supportive work environment.

Benefits

Medical, Dental, and Vision Benefits

401(k) Retirement Savings Plan

Paid Time Off

Short-term and Long-term Disability

Life Insurance

Qualifications

• 1+ year of experience in healthcare provider relations or contracting.
• Strong Excel skills including pivot tables and V-lookups.

Responsibilities

• Develop and maintain relationships with healthcare providers.
• Support financial and quality performance in provider engagements.

Skills

Healthcare Provider Contracting

Network Management

Excel (Pivot Tables, V-lookups)

Adobe File Management

Project Management

Education

Bachelor's Degree

Master's Degree

Tools

Excel

Adobe

Job description

Become a part of our caring community and help us put health first
Humana Healthy Horizons in Florida is seeking a Provider Engagement Professional who will develop and grow 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 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Provider Engagement Professional:

• 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.

Use your skills to make an impact

Required Qualifications

• Bachelor's Degree.
• Minimum of one (1) year of experience in health care or managed care provider contracting, network management or provider relations.
• Experience in Excel with ability to create pivot tables, V-look ups, and create basic formulas; knowledge to work with many individuals at same time without overriding data.
• Ability to convert files, merge and reorganize in Adobe.
• Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Demonstrated ability to manage multiple projects and meet deadlines.

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/Medicaid policies, processes and procedures.

Additional Information

• Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
• Travel: up to 80% of the time, 3-4 days per week within the following counties: Escambia, Santa Rosa, Okaloosa, Walton, Bay, Holmes, Washington, Jackson, Calhoun.
• Work Location: must reside within one of the above listed counties in Florida.
• Typical Work Days/Hours: Monday – Friday, 8:00 am – 5:00 pm EST.

Driving

This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

WAH Internet

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 recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees 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 employees 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.

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Limited Geography Remote - This is a remote position but located within a specific geography. 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, 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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.