Provider Engagement Executive

Humana • Indianapolis, IN

1d • $86,300 - $118,700 • Remote

About The Position

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.

Requirements

• Minimum of Associate's Degree
• 4 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
• Experience working with HEDIS and/or Stars measures and programs
• 1 or more years of demonstrated project management experience
• Experience partnering with senior leadership on strategic initiatives
• 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 within the State of Indiana with the ability to travel as needed

Nice To Haves

• Bachelor's Degree
• Established knowledge of reimbursement and bonus methodologies
• 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
• Located in Indianapolis, IN

Responsibilities

• Develops and grows positive, long-term relationships with physicians, providers and healthcare systems.
• Supports and improves financial and quality performance within the contracted working relationship with the health plan.
• Represents the scope of health plan/provider relationship across financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, provider performance, member experience, market growth, provider experience and operational excellence.
• Advises executives to develop functional strategies on matters of significance.
• Exercises independent judgment and decision making on complex issues regarding job duties and related tasks.
• Works under minimal supervision.
• Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree