Senior Provider Engagement Professional-1-1

Humana; United States; Remote; USD 71,000 - 98,000; Full time

Job summary

Join a forward-thinking company dedicated to improving health outcomes. As a Senior Provider Engagement Professional, you will play a vital role in fostering strong relationships with healthcare providers. Your expertise will drive financial performance and enhance the overall provider experience. This role combines strategic influence with hands-on project management, allowing you to make a significant impact in the healthcare landscape. Collaborate with a passionate team focused on delivering quality care and improving consumer experiences. If you're ready to contribute to meaningful change in healthcare, this opportunity is perfect for you.

Benefits

Medical benefits

Dental benefits

Vision benefits

401(k) retirement plan

Paid time off

Short-term disability

Long-term disability

Life insurance

Qualifications

• 5+ years of experience in healthcare or managed care with provider contracting.
• Proven skills in planning and presenting financial methodologies.

Responsibilities

• Develop and maintain relationships with healthcare providers to improve performance.
• Analyze complex data to support provider engagement and operational excellence.

Skills

Health care or managed care experience

Provider Contracting

Network Management

Provider Relations

Planning and preparation skills

Project management

Analytical skills

Education

Bachelor's Degree

Master's Degree

Job description

Become a part of our caring community and help us put health first
Humana Healthy Horizons Plan in Ohio seeks highly motivated Engagement Professionals to provide end to end provider experience as a member of our Medicaid team. The Senior Provider Engagement Professional develops and grows 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 Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Engagement Professional will work with key providers throughout the state, including Primary Care Providers (PCPs), FQHCs/RHCs, and Hospital Systems.

The Senior 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. Begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Use your skills to make an impact

Required Qualifications

• Bachelor's Degree
• 5 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
• 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

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

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. $71,100 - $97,800 per year. This job is eligible for a bonus incentive plan 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.