Unknown Company is hiring a Sr Provider Engagement Prof

Humana is looking for a Senior Provider Engagement Professional to develop long-term, productive relationships with physicians, providers, and healthcare systems. You will be instrumental in supporting and improving the financial and quality performance for our health plan, making key decisions on complex issues with considerable autonomy.

What You'll Do

• Represent the full scope of the health plan/provider relationship across financial performance, incentive programs, quality and clinical management, and population health.
• Manage performance and improvement initiatives related to data sharing, connectivity, documentation, coding, HEDIS, and STARs.
• Influence department strategy and make decisions on moderately complex to complex technical approaches for project components.
• Drive operational improvements and work effectively within a matrixed organization to influence change.

What We're Looking For

• Must live in the State of Illinois.
• Ability to travel throughout Illinois as needed for the role (up to 75%).
• Bachelor’s Degree plus 3+ years of progressive experience in managed care operations, including network management and provider relations -OR- equivalent work experience plus 5+ years.
• Experience working for or with key provider types (e.g., primary care, FQHCs, hospitals, nursing facilities, HCBS and LTSS providers).
• Prior experience working in and a strong understanding of Illinois Medicaid, provider landscape, and networks.
• Proven planning, preparation, and presenting skills, with established knowledge of reimbursement and bonus methodologies.
• Demonstrated ability to manage multiple priorities in a fast-paced environment.
• Experience working in a matrixed organization and influencing change and direction.
• Intermediate to advanced knowledge of Microsoft Suite applications (Word, Excel, PowerPoint).
• Valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

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 Word
• Microsoft Excel
• Microsoft PowerPoint

Team & Environment

You will be part of a matrixed organization, requiring strong collaboration and influence skills to drive initiatives forward.

Benefits & Compensation

• Compensation range: $71,100 - $97,800 per year.
• Benefits effective on day 1.
• 401k, Medical, Dental, and Vision insurance.
• Variety of supplemental insurances.
• Tuition assistance.
• 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 role, but you must live and work within the State of Illinois.

Humana is an equal opportunity employer and does not discriminate because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. We take affirmative action to employ and advance individuals with disability or protected veteran status.