Director, Provider Engagement

Humana • Louisiana, MO

1d • Hybrid

About The Position

Become a part of our caring community and help us put health first The Director, Provider Engagement develops and grows positive, long-term relationships with physicians, providers, and healthcare systems. These relationships intend to support financial and quality performance within the contracted working relationship with the health plan. The Director, Provider Engagement requires an in-depth understanding of how organization capabilities interrelate across the function or segment. You will: Lead strategic relationships between the health plan and providers, focusing on financial performance, incentive programs, quality improvement, clinical management, and population health programs. Oversee and guide enhancements in data sharing, connectivity, documentation, coding accuracy, HEDIS and STARs performance, and operational processes to improve provider outcomes and member experience. Implement new or updated programs and large-scale projects, ensuring understanding of technical and operational procedures for execution. Develop strategic plans to support market growth, provider satisfaction. Provide informed input into functional strategy, contributing to organizational goals and performance improvement. Collaborate with all partners to foster provider engagement and deliver measurable improvements across all main performance areas. Use your skills to make an impact

Requirements

• Master's degree from an accredited institution.
• Minimum of 8 years of experience in provider contracting or a related field.
• At least 5 years of proven management experience, demonstrating leadership and team development skills.
• 5 years of direct experience working with Louisiana Medicaid programs, including familiarity with relevant policies and regulations.
• Demonstrated relationship-building skills, with a proven ability to establish and strengthen partnerships with providers and stakeholders through effective verbal and written communication of complex information.
• Demonstrated ability to proficiently utilize Microsoft Office applications—including Word, Excel, PowerPoint, Teams, and Outlook—for preparing reports, conducting analyses, and delivering effective presentations.
• Willingness to travel up to 25% of the time to meet our needs.
• Residency within the state of Louisiana is mandatory.

Nice To Haves

• Prior work experience in the health solutions industry with demonstrated success directing and leading teams
• Proficiency in quality improvement processes, analyzing and interpreting financial trends

Responsibilities

• Lead strategic relationships between the health plan and providers, focusing on financial performance, incentive programs, quality improvement, clinical management, and population health programs.
• Oversee and guide enhancements in data sharing, connectivity, documentation, coding accuracy, HEDIS and STARs performance, and operational processes to improve provider outcomes and member experience.
• Implement new or updated programs and large-scale projects, ensuring understanding of technical and operational procedures for execution.
• Develop strategic plans to support market growth, provider satisfaction.
• Provide informed input into functional strategy, contributing to organizational goals and performance improvement.
• Collaborate with all partners to foster provider engagement and deliver measurable improvements across all main performance areas.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Director