Provider Engagement Executive

About the role

The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan.

Responsibilities

• Develops and manages functional strategies for segment-specific provider relations and contracting.
• Works on problems of diverse scope and complexity ranging from moderate to substantial.
• Represents the scope of health plan/provider relationship across areas such 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 on matters of significance.
• Manages multiple projects and meets deadlines.
• Analyzes and interprets financial trends for health care costs, administrative expenses, and quality/bonus performance.
• Travels to value-based provider groups and regional and corporate Humana offices for training or meetings as needed.

Requirements

• 6 or more years of health care or managed care operations to include provider relations and/or provider contracting.
• 2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives.
• Proven planning, preparation, and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Comprehensive knowledge of Medicare policies, processes, and procedures.
• Must reside in either Phoenix, AZ or Denver, CO with the ability to travel as needed, including overnight within the region (CA, NV, AZ, CO, NM).

Preferred Qualifications

• Bachelor's Degree, preferred.
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Limited life insurance.
• Many other opportunities.

Pay Range

• $86,300 - $118,700 per year.

About Us

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.