Provider Engagement Executive - San Antonio TX

Profile

Description

The 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 Provider Engagement Executive 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. 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

Bachelor's Degree.

5 years of Health care or managed care with Provider Relations, Population Health, Provider Contracting or Network Management experience.

2 years of demonstrated experience managing projects and strategic initiatives in partnership with senior leadership

Ability to analyze data and recommend strategy

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.

Preferred Qualifications

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

Additional Information

As part of our hiring process, we will be using an exciting interviewing technology provided by Montage, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

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