Provider Engagement Account Executive

Profile

Description

The Provider Engagement Account 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 Account 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

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

Preferred Qualifications

Master's Degree

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

Additional Information

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

40

Company info

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