Humana · 1 day ago
Provider Engagement Executive
Remote Massachusetts
Full-time
Remote
Senior Level
$85K/yr - $116K/yr
5+ years exp
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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.
Work on problems of diverse scope and complexity ranging from moderate to substantial.
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.
Advise executives to develop functional strategies on matters of significance.
Exercise independent judgment and decision making on complex issues regarding job duties and related tasks, and work under minimal supervision.
Qualification
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Required
Bachelor's Degree
Understanding of MRA, STARS/ HEDIS measures
5 or more years of health care or managed care with Provider Performance, Provider Contracting, Network Management or Provider Relations experience
2 or more years of demonstrated project management or provider performance management experience
Experience partnering with senior leadership on strategic initiatives
Established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Comprehensive knowledge of all Microsoft Office applications
Ability to travel within New England region up to 15% of the time
Preferred
Master's Degree
Knowledge of practice management
Familiarity with electronic data connectivity
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
Humana is a health insurance provider for individuals, families, and businesses.
10,001+ employees
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)
Funding
Current Stage
Public CompanyTotal Funding
$6.82B2024-03-11Post Ipo Debt· $2.25B
2023-11-02Post Ipo Debt· $1.32B
2023-02-27Post Ipo Debt· $1.25B
Leadership Team
Bruce D. Broussard
President and Chief Executive Officer
Susan M. Diamond
CFO
Recent News
MedCity News
2024-11-13
2024-11-12
Morningstar, Inc.
2024-11-11
Company data provided by crunchbase
