Senior Network Performance Professional

🔥 13 hours ago

🌵 Arizona, California, +3 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🌺 Hawaii – Remote 🎰 Nevada – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟠 Senior

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Work with providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies • Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience • Actively monitor and analyze provider performance data to identify areas for improvement • Act as a liaison for providers to access Humana resources • Educate provider groups on reward programs and target metrics • Resolve provider abrasion issues effectively • Partner with internal teams to track and report on market performance

🎯 Requirements

• Bachelor’s degree • 3+ years of experience in healthcare, Medicare and/or managed care • Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system • Ability to drive interoperability and understanding of Consumer/Patient Experience • Experience building relationships with physician groups and influencing execution of recommended strategy • Strong communication and presentation skills, both verbal and written • Experience with process and quality improvement • Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint

🏖️ Benefits

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