Remote Provider Engagement & Performance Specialist

Humana Inc; Florida; Hybrid; USD 59,000 - 81,000; Full time

Job summary

Humana Inc. and its CenterWell Senior Primary Care division seek a Provider Engagement Professional to build and nurture relationships with physicians, providers and health systems.

You will analyze financial and quality performance within contracted relationships and determine the best actions to improve outcomes. The role reports to the Director, Provider Engagement and involves interpreting data, coordinating with teams on reimbursement and bonus programs, and supporting improvements in

Qualifications

• Bachelor's degree required.
• 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.

Responsibilities

• 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.
• Interprets and independently determines the appropriate courses of action for assigned work.
• Reports to the Director, Provider Engagement.
• Represents the scope of health plan/provider relationship across areas including financial performance, incentive programs, quality and clinical management, population health, data sharing and more.
• Supports improvements in member experience, market growth and operational excellence.

Skills

Provider Contracting

Network Management

Provider Relations

Service fund reports

Reimbursement & bonus methodologies

Project management

Customer experience focus

Education

Bachelor's Degree

Master's Degree

Job description

Humana Inc. and its CenterWell Senior Primary Care division seek a Provider Engagement Professional to build and nurture relationships with physicians, providers and health systems.

You will analyze financial and quality performance within contracted relationships and determine the best actions to improve outcomes. The role reports to the Director, Provider Engagement and involves interpreting data, coordinating with teams on reimbursement and bonus programs, and supporting improvements in