Manager, Provider Engagement

Humana • Chittenden, VT

3d • Remote

About The Position

Become a part of our caring community and help us put health first The Manager, Provider Engagement 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 Manager, Provider Engagement works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. The Manager, Provider Relations HIDE SNP, leads a team of provider relations associates responsible for growing positive, long-term relationships with network PCP/Medical, behavioral health and Long-Term Services and Support (LTSS) providers in Humana’s Dual Integrated (HMO D-SNP) in Michigan plan through day-to-day, front-line relationship management. The Manager is responsible for facilitating a positive provider relationship management experience, through provider training, education, responding to provider inquiries, and resolving issues or complaints. Understands key internal systems that support the provider experience. This individual identifies and leads opportunities to make changes to improve operations across teams and works on general matters in which analysis of issues, data and processes require evaluation of multiple factors. Use your skills to make an impact

Requirements

• The applicant must be located in MI or willing to relocate to the Metro Detroit area.
• Ability to travel as needed throughout Michigan
• Bachelor’s Degree with 4 or more years of progressive experience in managed care operations, including network management and provider relations OR High School Diploma with 7 or more years of progressive experience in managed care operations, including network management and provider relations.
• Experience working for or with key provider types (such as primary care, FQHCs, hospitals, nursing facilities, and/or HCBS and LTSS providers).
• 2+ years of management and team building experience including supervising a staff of at least 5-10 employees.
• Prior experience working in and strong understanding of Medicare and Medicaid /HIDE DSNP
• Proven planning, preparation and presenting skills.
• Demonstrated ability to manage multiple projects and meet deadlines.
• Exceptional relationship management skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of Microsoft Office applications.

Nice To Haves

• Master’s Degree.
• Experience in and/or understanding of Michigan’s Dual Integrated (HMO D-SNP) provider landscape and networks.
• Contract negotiation and implementation experience.

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: Manager
• Number of Employees: 5,001-10,000 employees