SNP Provider Engagement Professional

Profile

Description

The SNP Provider Engagement Executive 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 Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

SNP Provider Engagement Executive

This role will provide strategic and operational leadership for the new D-SNP, C-SNP plans in Missouri, Oklahoma and Arkansas. This position is being created to develop and manage successful SNP plans in 3 distinct markets, and explore SNP expansion. The work encompasses health plan/provider relationships, financial performance, quality and clinical programs, support documentation and connectivity, Stars performance and operational performance.

Leads the work and deliverables of multiple, complex projects or programs, through conception to implementation, that impact multiple departments, processes, systems, functions and products for SNP products. Projects range from short to multiyear duration.


Develops and implements strategic business plan to achieve regional and enterprise goals. Collaboration in developing strategies within the Region with Provider Experience, HSO, Finance, and MRA/Stars departments along w appropriate constituents.

Develop partnership relationship with contracted provider groups.

Able to work within established product compliance guidelines

Leads complex projects to support the regional strategy.

Identifies gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad view of the organization.

Collaborates and partners with other functional managers, other business areas across/within segments or other business areas to ensure all workflow processes and inter-dependencies are identified and addressed.

Consults with constituents (these may be internal and/or external) to scope/define project.

Influences change in order to improve performance results, organization effectiveness and/or systems/quality/services.


Required Qualifications


Bachelor's Degree

6 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

Demonstrated experience managing projects and partnering with senior leadership on strategic initiatives

Proven planning, preparation and presentation skills

Demonstrated internal/external collaboration and relationship building with all levels of leadership

Comprehensive knowledge of all Microsoft Office applications

Ability to travel up to 35% within the region, as needed

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


Preferred Qualifications


Master's Degree

Previous experience working with SNP plans in a Medicare Advantage/Medicaid environment

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

Proven track record in meeting plan goals

Ability to satisfy customers needs and develop alternatives to resolve issues.


Additional Information

This position will be a remote position, however, you must live within the region, in order to be considered (AR, MO, OK, KS)

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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