044 CenterWell Pharmacy, Inc. is hiring a Program Delivery Lead to support programs designed to maximize value-based relationships with Providers in the Gulf South Region. You will drive network performance with a focus on interoperability, MRA coding, and closing gaps in care, using an understanding of electronic health data solutions to impact the business and members.
What You'll Do
- Drive the quantity and quality of EMR data connections and supplemental data files.
- Partner with leaders regarding implementation planning, communicating program results, and advising executives to develop functional strategies.
- Help providers’ systems perform better by working on challenges with different EMR programs.
- Identify new interoperability targets for Epic, eCW and Athena using available lists and sources.
- Collaborate with Interoperability Recruiting and Implementation team on regional provider Implementations in Process.
- Develop and maintain regional Live Connection Tracking report.
- Manage Implementations in Process reporting to track progress and follow up with Interoperability teams.
- Follow progress, submit, and track the Interoperability Support Request Intake process.
- Consider potential regional and provider goals and targets for next implementations.
- Collaborate to establish priorities based on next product for implementation.
- Manage and develop a regional process to track providers in progress: push to contracting and follow up to communicate progress until fully executed.
- Identify and research groups with low performance measures related to prospective programs.
- Engage and assist market with understanding of providers’ Interoperability products.
- Coordinate scheduling and communication for providers’ kick-off meetings and provide resources to the team and providers.
- Oversee and track regional health data new connections, while maintaining and communicating regional data outage report.
- Report both HEDIS and Lab data feeds where providers have a missing data submission.
- Manage Data Retrieval Method maximization, including Cotiviti retrieval methods and identify sites with active interoperability pathways to ensure appropriate retrieval method is implemented.
What We're Looking For
- 5 or more years of experience in Managed Care with Stars, Risk Adjustment or Network Management experience.
- 2 or more years of experience in project work or process improvement.
- Advanced working knowledge of MS Excel (vLookups, pivot tables).
- Experience partnering with leadership on strategic initiatives.
- Demonstrated ability to articulate ideas effectively in both written and oral forms.
- Ability to self-direct, take initiative and meet deadlines.
- Use of independent judgment to analyze variable factors and determine the best course of action.
- Strong time-management and prioritization skills, with stellar attention to detail.
- Excellent organizational skills, with ability to manage multiple priorities, maintain clear structure in complex workflows and ensure timely, accurate completion of responsibilities in fast-paced environment.
- Impeccable attention to detail, identifying discrepancies, improving data integrity, and elevating operational accuracy across high impact initiatives.
- Strong analytical thinking and problem-solving skills.
- Proven relationship building skills with ability to act as a liaison between corporate and market professional and providers in the field.
Nice to Have
- Bachelor's degree or higher in a related field.
- PMP certification a plus.
- Experience working with health data collected from Electronic Health Records (EHR), Health Information Systems (HIS), or other healthcare IT systems.
- Six Sigma Certification also a plus.
- Live within the stated region (AL, MS, TN, LA, SW VA).
Technical Stack
- MS Excel
- Epic
- eCW
- Athena
Team & Environment
Partners with corporate teams and professionals in the field.
Benefits & Compensation
- Compensation: $115,200 - $158,400 per year
- 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.
Work Mode
This is a remote position open to candidates located in the United States.
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.
