Manager, Network Performance

Humana

1d • Remote

About The Position

As the Manager of Network Performance, you will lead a team of Network Performance Professionals dedicated to improving provider performance and enhancing Stars ratings. Your role is pivotal in fostering a collaborative and supportive environment where your team can thrive. By building and maintaining strong relationships with assigned physician groups, your team will implement strategies and tactics that elevate network performance. You will report directly to the Director, Quality and Risk Adjustment. This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will be responsible for guiding, mentoring, and developing your team to achieve their full potential, ensuring that they are equipped with the knowledge and tools necessary to excel in their roles.

Requirements

• 5+ years Medicare experience and understanding of value-based care model
• Knowledge of HEDIS/Stars and CMS quality measures
• 3+ years demonstrated capability with leading, coaching, and developing associates formally or informally (training, SME, etc.)
• Proficiency in analyzing and interpreting healthcare data and trends
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint
• Experience presenting to internal and external customers, including high-level leadership
• Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care

Nice To Haves

• Bachelor's Degree in Business, Finance, Healthcare, or a related field
• Progressive management experience, leading and developing others
• Progressive experience in the health solutions industry, particularly with interoperability
• Prior managed care or Medicaid experience
• Background working in quality improvements

Responsibilities

• Leads a team of up 11 provider-facing direct reports, guiding them in their efforts to improve provider performance
• Serves as the expert on CMS Stars program, HEDIS, CAHPS, and HOS, providing guidance and support to the team
• Builds and maintains strong relationships with provider practices, leading the team's discussions to find and implement improvement opportunities, develop workflows, and monitor outcomes while focusing on solutions that enhance provider engagement
• Informs and leads the team based on enterprise, regional, and departmental KPIs and objective and key results, ensuring alignment with organizational goals and objectives
• Partners with other departments to advance performance in Provider Engagement, Stars Improvement, MRA, Interoperability, Clinical, Corporate Partners, and Provider Contracting to improve provider/member engagement.
• Leads interdepartmental and team strategy meetings
• Ingests data from various sources, analyze it, and informs the team and leadership of learnings
• Creates data-supported, focused education to drive team tactics and improve performance
• Directs the team's focus toward solutions that maximize provider abilities to engage effectively
• Owns decisions related to people leadership, resources, strategic planning, and tactical operations for the team
• Reviews and communicates performance results of the team and initiatives
• Articulates and models desired culture attributes, actively supporting team engagement, performance, well-being improvement plans, and team activities

Benefits

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
• And more

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees