Senior Provider Engagement Professional - Work at Home Ohio Work at Home Kentucky

Profile

Description

The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

The Senior Provider Engagement Professional represents the scope of health plan/provider relationship across such areas 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. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.


Virtual and in-person presentations to provider groups
Collaborate with provider groups and internal peers to elevate STARS scores
Providing support and consultation to provider groups
STARS quality education


Required Qualifications


5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
Comprehensive knowledge with MS Office Word, PowerPoint, and Excel
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 Qualifications


Bachelor's Degree
Master's Degree
STARS/HEDIS knowledge
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


Additional Information

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

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