Market Development Advisor

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $94.9k - $130.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

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

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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