Provider Engagement Executive

Provider Engagement Executive

Humana Healthy Horizons is seeking a Provider Engagement Executive to develop and grow positive, long-term relationships with physicians, providers, and healthcare systems 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.

Required Qualifications:

• Must reside in Ohio
• Bachelor's Degree
• 8 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 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 needed
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications:

• Master's Degree
• 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

Scheduled Weekly Hours: 40

Pay Range: $86,300 - $118,700 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental, and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.

Equal Opportunity Employer: It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.