Provider Engagement Professional - TN​/GA Markets

Provider Engagement Professional – TN/GA Markets

Location
:
Nashville, TN & Atlanta, GA markets (must reside in Nashville metro area)

Seniority Level
:
Mid‑Senior;
Employment Type
:
Full‑time;
Job Function
:
Other;
Industries
:
Hospitals and Health Care

Pay Range
: $59,300 – $80,900 per year (base pay; additional incentive based on performance)

Schedule
: 40 hours per week;
Work Setting
:
Remote with occasional travel (Local travel 75%, Regional travel 25%, Road travel 50%)

• Develop and grow long‑term relationships with physicians, providers and healthcare systems to support financial and quality performance.
• Interpret and independently determine appropriate courses of action in a variety of work assignments.
• Represent the scope of the health plan/provider relationship in areas such as financial performance, incentive programs, quality, clinical management, population health, data sharing, connectivity, documentation, coding, HEDIS/STARs performance, operational improvements, member experience, market growth, and operational excellence.
• Understand and align with department, segment and organizational strategy and operating objectives.
• Make decisions regarding work methods with minimal direction while following established guidelines and procedures.

• Bachelor’s Degree or equivalent experience.
• 1–5 years of health care or managed care experience in provider contracting, network management or provider relations.
• Proven planning, preparation and presentation skills, with knowledge of reimbursement and bonus methodologies.
• Ability to manage multiple projects and meet deadlines.
• Experience in value‑based care, data analysis, database care, HEDIS/STARs, MSO and payor environments.
• Highly service‑oriented and passionate about improving consumer experiences.
• Valid driver’s license and willingness to travel within and around Nashville, TN and Atlanta, GA markets.

• 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.

Employees working from home must provide a minimum internet download speed of 25 Mbps and upload speed of 10 Mbps. Appropriate telephone equipment will be supplied. Employees in California, Illinois, Montana, or South Dakota may receive a bi‑weekly payment for internet expense.

Health benefits effective day one; paid time off, holidays, volunteer time, jury duty pay; recognition pay; 401(k) retirement savings plan with employer match; tuition assistance; scholarships for eligible dependents; parental and caregiver leave; employee charity matching program;
Network Resource Groups; career development opportunities; occasional travel to Humana offices may be required.

Hire Vue video interview technology will be used.

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 advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.

This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Referrals increase your chances of interviewing at Center Well Senior Primary Care by 2x.