Provider Engagement Executive

Humana Inc. Huntsville , AL 35801

Posted 2 weeks ago

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.

Responsibilities

The Provider Engagement Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

Required Qualifications

  • Bachelor's Degree

  • 8+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

  • 2+ 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 all Microsoft Office applications

  • Ability to travel as required up to 25% of the time

Preferred Qualifications

  • Masters Degree

  • Experience in Value Based care

  • Understanding of HEDIS gap closures

  • MRA experience

  • 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

This position will be "work at home", however, must reside in the Huntsville, AL area as regular travel will be required within the region

Scheduled Weekly Hours
40


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Provider Engagement Executive

Humana Inc.