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. This role works on problems of diverse scope and complexity, representing the 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 related 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, working under minimal supervision and using analysis of variable factors to determine the best course of action.
Responsibilities
- Develop and maintain long-term relationships with physicians, providers, and healthcare systems.
- Support and improve financial and quality performance within contracted relationships.
- Address issues related to financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS, and STARs performance.
- Advise executives on functional strategies for provider performance, member experience, and operational excellence.
- Manage multiple projects and meet deadlines.
- Partner with senior leadership on strategic initiatives.
Requirements
- Minimum of an Associate's Degree.
- 4 or more years of healthcare or managed care experience in Provider Contracting, Network Management, or Provider Relations.
- Experience working with HEDIS and/or Stars measures and programs.
- 1 or more years of demonstrated project management experience.
- Proven planning, preparation, and presentation 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.
Preferred Qualifications
- Bachelor's Degree.
- Established knowledge of reimbursement and bonus methodologies.
- Proficiency in analyzing and interpreting financial trends for healthcare costs, administrative expenses, and quality/bonus performance.
- Comprehensive knowledge of Medicare policies, processes, and procedures.
- Located in Indianapolis, IN.
Additional Information
This role is remote/work at home, but you must live in the State of Indiana, with the ideal candidate being located in Indianapolis.
Scheduled Weekly Hours: 40
Pay
The pay range reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The range may vary based on geographic location and individual pay will depend on demonstrated job-related skills, knowledge, experience, education, and certifications.
$86,300 - $118,700 per year
This job is eligible for a bonus incentive plan based on company and/or individual performance.
Benefits
Humana offers competitive benefits designed to support whole-person well-being, including:
- Medical, dental, and vision benefits.
- 401(k) retirement savings plan.
- Paid time off (including paid holidays, parental, and caregiver leave).
- Short-term and long-term disability.
- Life insurance.
About Us
Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through Humana insurance services and CenterWell healthcare services, we make it easier for millions of people to achieve their best health by delivering care and services when needed. Learn more at Humana.com and CenterWell.com.