Supervisor Provider Engagement - WAH

Profile

Description

The Supervisor, Provider Engagement 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 Supervisor, Provider Engagement works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach.

Responsibilities

The Supervisor, Provider Engagement 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. Decisions are typically are related to schedule, plans and daily operations. Performs escalated or more complex work of a similar nature, and supervises a group of typically support and technical associates; coordinates and provides day-to-day oversight to associates. Ensures consistency in execution across team. Holds team members accountable for following established policies.

Supervises 7-10 on-shore associates

Supervises team of off-shore associates (Permanent and Temporary)

Required Qualifications

2 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies

Demonstrated ability to manage multiple projects and meet deadlines

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

Preferred Qualifications

Bachelor's Degree

2 years of prior supervisory experience in a a fast paced operational setting; driven by quality metrics

Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance

Comprehensive knowledge of Dental policies, processes and procedures

Scheduled Weekly Hours

40

Company info

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