Senior Healthcare Network Consultant

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🔥 54 minutes ago

🏈 Ohio, South Carolina, +3 more states – Remote

🏈 Ohio – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote

💵 $78.4k - $107.8k / year

⏰ Full Time

🟠 Senior

🛜 Network Engineer / Network Administrator

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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 improve 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. • Collaborate to develop tailored action plans and communicate actionable insights to improve performance. • Monitor and analyze provider performance data to identify areas for improvement. • Implement strategies to enhance outcomes and provide ongoing support to providers. • Act as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools. • Facilitate communication between providers and our teams to ensure seamless access to necessary support. • Educate provider groups on reward programs and target metrics, collaborating to achieve established goals. • Resolve provider abrasion issues, ensuring a positive and collaborative relationship between Humana and its providers. • Partner with our teams to track and report market performance, ensuring alignment with organizational goals.

🎯 Requirements

• 2 or more years of Experience with Medicare or managed care • Live in CST or EST and work during 8am-5pm CST or EST • 3 or more years of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system • 1 or more years of understanding of Consumer / Patient Experience • 2 or more years of experience building relationships with physician groups and influencing execution of recommended strategy • 1 or more years of experience with focus on process and quality improvement • Comprehensive knowledge of all Microsoft Word, Excel and PowerPoint

🏖️ Benefits

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