Provider Engagement Executive

🔥 1 minute ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $86.3k - $118.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Executive

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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

• Develop and grow positive, long-term relationships with physicians, providers and healthcare systems • Support and improve financial and quality performance within contracted health plan relationships • Represent the health plan/provider relationship across financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, provider performance, member experience, market growth, provider experience and operational excellence • Advise executives and develop functional strategies, often segment-specific, on matters of significance • Exercise independent judgment and decision-making on complex issues • Analyze variable factors and determine the best course of action • Travel occasionally to Humana offices for training or meetings

🎯 Requirements

• 5 or more years of health care or managed care experience with Provider Contracting, Network Management or Provider Relations • 2 or more years of demonstrated project management experience • Experience partnering with leadership on strategic initiatives • Proven planning, preparation and presenting skills • Established knowledge of reimbursement and bonus methodologies • 2+ years of experience working with Stars/HEDIS measures • Must live in the State of Louisiana • Ability to travel as needed (up to 25%) • Bachelor's Degree preferred • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance • Comprehensive knowledge of Medicare policies, processes and procedures • Advanced working knowledge of MS Excel, including vLookups and pivot tables • Minimum download speed of 25 Mbps and upload speed of 10 Mbps • Ability to work from a dedicated space 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 • Personal wellness support • Healthcare decision support