Specialty Provider Engagement Executive

Profile

Description

The Specialty 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 Specialty Provider Engagement Executive works with a variety of independent and hospital affiliated specialist groups, representing the scope of health plan/provider relationship. The Specialty Provider Engagement Executive will work across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing and operational improvements. The Specialty Provider Engagement Executive will work collaboratively with Humana corporate and market resources to specifically improve specialty provider performance, member experience, and operational excellence. The SPEX will work with specialty physician and practice leaders to develop functional strategies on matters of significance. The SPEX exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works within a team under minimal supervision and uses independent judgment requiring analysis of variable factors in determining the best course of action.

Required Qualifications

Bachelor's Degree

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 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 up to 50% within the region

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

Understanding of Value based care

Clinical experience or background (RN, Pharmacy, etc)

Comprehensive knowledge of Medicare policies, processes and procedures

Additional Information

This position will be remote within the region (OH, MI, IN). As we return to normal operations, this person will be required to travel to provider offices within the region.

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.

Equal Opportunity Employer

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Company info

Humana Inc.
Website : http://www.humana.com