Humana Provider Engagement Executive in Centennial, Colorado
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.
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.
5 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
2 or more years of demonstrated project management experience, partnering with senior leadership and cross-functional teams on strategic initiatives
Proven planning, preparation and presentation skills
Understanding of reimbursement and bonus methodologies
Comprehensive knowledge of all Microsoft Office applications
Driver's license with reliable transportation with the ability to travel within the State of Colorado as required (up to 25%)
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Understanding or experience working with Value-based providers
Comprehensive knowledge of Medicare policies, processes and procedures
Under the current circumstances, this position will be "work at home", however, you must live in the Centennial, CO area as you will be based in this office as we return to our normal operations
Scheduled Weekly Hours
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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