Market Development Advisor

🕒 3 dias atrás

🌽 Illinois – Remoto

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💵 $94.900 - $130.500 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🦅 Patrocina Visto H1B

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👻 Score fantasma 0%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Humana

Humana

10.000+ funcionários

Fundada em 1961

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.

Descrição

• Advise the Provider Services Director on strategic and day-to-day operations across provider relations, claims education, provider engagement, and provider performance improvement • Establish infrastructure to measure KPIs and metrics for compliance with managed care contractual requirements • Develop and manage annual updates to the market's Provider Support Plan and required state reporting • Oversee provider communications, including fax blasts, emails, bulletins, website, and provider portal content updates, from content development through approval • Manage provider training and education strategy and create market-based provider materials • Contribute to provider manuals and required training materials • Support implementation of contractual requirements and day-to-day business processes before market go-live • Lead process development and improvement for efficiency, standardization, and best practices in Illinois • Drive strategic initiatives related to the Medicaid LTSS/HCBS provider journey and provider relationship management model • Facilitate workgroup calls, meetings, and discussions to execute the Provider Support Plan • Partner with the corporate Medicaid Provider Services team to roll out segment-wide process or technology enhancements • Partner cross-functionally within the market and across the enterprise on significant matters • Exercise independent judgment and decision-making on complex issues with minimal supervision

🎯 Requisitos

• Must reside in the state of Illinois • Bachelor's Degree • 6+ years of related experience, including provider relations or engagement, provider communications and education, and/or related health plan operations • 2+ years of project management experience • Experience working in Illinois Medicaid • Ability to identify, prioritize, and solve complex business problems • Excellent interpersonal, organizational, written, and oral communication and presentation skills • Proven experience writing and delivering presentations to members of the management team and internal business partners • Preferred: Master's Degree • Preferred: Understanding of managed care contracts, including contract language and reimbursement • Preferred: Familiarly with LTSS/HCBS providers and/or DSNP/Medicaid-Medicare integration • Preferred: Strong understanding of health plan operations • Preferred: Experience operating in a matrixed environment • Preferred: Project management certification • Home internet service with minimum download speed of 25 Mbps and upload speed of 10 Mbps • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefícios

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Dedicated home workspace arrangement • Remote work arrangement with occasional travel to Humana offices for training or meetings

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