Provider Engagement Executive

Role Description

The 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.

• Represents the scope of health plan/provider relationship across various areas including:
  • Financial performance
  • Incentive programs
  • Quality and clinical management
  • Population health
  • Data sharing
  • Connectivity
  • Documentation and coding
  • HEDIS and Stars performance
  • Operational improvements
• Advises executives to develop functional strategies on significant matters.
• Exercises independent judgment and decision-making on complex issues regarding job duties and related tasks.
• Works under minimal supervision, using independent judgment requiring analysis of variable factors to determine the best course of action.

Qualifications

• 6 or more years of health care or managed care operations experience, including provider relations and/or provider contracting.
• Experience working with HEDIS and/or Stars measures and programs.
• 2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives.
• Proven planning, preparation, and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Demonstrated ability to manage multiple projects and meet deadlines.
• Comprehensive knowledge of Medicare policies, processes, and procedures.
• Must reside in either Phoenix, AZ or Denver, CO with the ability to travel as needed, including overnight within the region (CA, NV, AZ, CO, NM).

Requirements

• To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service must meet the following criteria:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
  • Humana reserves the right to require associates to upgrade their internet service if necessary.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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 and many other opportunities.

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc.

$86,300 - $118,700 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.