CenterWell Pharmacy, Inc. is seeking a Provider Engagement Executive to cultivate long-term partnerships with physicians, providers, and healthcare systems. This role is central to enhancing financial and quality performance within our health plan’s contracted relationships, focusing on strategic alignment and operational improvement.
What You'll Do
- Develop and grow positive, long-term relationships with physicians, providers, and healthcare systems.
- Support and improve financial and quality performance within the contracted working relationship with the health plan.
- Represent the scope of health plan/provider relationship across areas such as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, and operational improvements.
- Advise executives to develop functional strategies (often segment specific) on matters of significance.
- Exercise independent judgment and decision making on complex issues regarding job duties and related tasks, and work under minimal supervision.
What We're Looking For
- Bachelor's Degree and/or equivalent experience.
- 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.
Nice to Have
- 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.
Technical Stack
- Microsoft Office applications
Benefits & Compensation
- Compensation: $86,300 - $118,700 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 hybrid role with remote work options.
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.
