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 identifies opportunities to positively impact trends through analysis of effectiveness and efficiency data. Develops and/or executes strategy to positively impact trends. Interfaces with provider groups on a regular basis. 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


2 years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
Comprehensive knowledge of Microsoft Office Applications including Excel and PowerPoint
In-depth experience in Microsoft Excel including formulas, pivots, charts, and graphs
Strategic thinking and planning capabilities; organized and detail-oriented
Excellent written and verbal communication skills
Excellent relationship building skills with both internal and external partners
Willingness to manage and prioritize diverse projects
Reliable transportation, valid driver's license with the ability to travel up to 30% of the time within the Mid-South region (Tennessee, Alabama, Southwest Virginia)


Preferred Qualifications


Bachelor's Degree
Business and financial acumen in the health care field
Proficiency in analyzing and interpreting financial trends for health care costs
Experience and understanding of Managed Care
Understanding of managed care reimbursement methodologies
Comprehensive knowledge of Medicare policies, processes and procedures
Health care or managed care experience in Provider Contracting, Network Management, Provider Relations or healthcare analytics


Additional Information

This position is considered remote/work at home, however, the preferred candidate will live in Tennessee or Alabama.

Work at Home Information

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:


At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


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Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

Company info

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