67 applicants

Company

Humana · 16 hours ago

Provider Engagement Professional 2

Remote Florida

Full-time

Remote

Entry, Mid Level

$59K/yr - $81K/yr

1+ years exp

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H1B Sponsor Likely

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Responsibilities

Develop and grow positive, long-term relationships with physicians, providers and healthcare systems.

Support and improve financial and quality performance within the contracted working relationship with the health plan.

Represent the scope of health plan/provider relationship across areas such as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.

Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Make decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

Follow established guidelines/procedures.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Health care experienceProvider ContractingNetwork ManagementProvider RelationsReimbursement methodologiesBonus methodologiesDeadline managementFinancial analysisInterpreting financial trendsMedicare policiesMedicare processesMedicare proceduresProject managementPassion for consumer experience

Required

Must reside in the state of Florida

Bachelor's Degree

1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies

Demonstrated ability to manage multiple projects and meet deadlines

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred

Master's Degree

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

Benefits

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off

Company and personal holidays

Volunteer time off

Paid parental and caregiver leave

Short-term and long-term disability

Life insurance

Company

Humana

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10001+ employees

http://www.humana.com

H1B Sponsorship

Humana has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (217)

2022 (257)

2021 (258)

2020 (107)