Provider Engagement Executive - Knoxville/Tri-Cities TN

Humana • Knoxville, TN

2d • Remote

About The Position

Become a part of our caring community and help us put health first The Provider Engagement Executive 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 Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial. The Provider Engagement Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact

Requirements

• 2 or more years of Health care or managed care with Provider Relations, Provider Contracting, or Network Management experience
• Minimum of 1 year of experience working with provider groups on HEDIS and/or Stars performance improvement
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
• Experience partnering with senior leadership on strategic initiatives
• Established knowledge of reimbursement and bonus methodologies
• Proven planning, preparation and presenting skills
• Demonstrated ability to manage multiple projects and meet deadlines
• Comprehensive knowledge of all Microsoft Office applications
• Must be located in Knoxville/Tri-Cities area with the ability to travel as needed within Gulf South Market (LA, MS, AL, TN)

Nice To Haves

• Bachelor's Degree
• Established provider relationships within the Gulf South Market
• Demonstrated project management experience
• Comprehensive knowledge of Medicare policies, processes and procedures

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