Senior Provider Engagement Professional

Role Overview

The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted relationship with the health plan. The work assignments involve moderately to complex issues where analysis of situations or data requires an in-depth evaluation of variable factors.

The role encompasses the scope of the 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, operational improvements, and other factors related to provider performance, member experience, market growth, provider experience, and operational excellence. The Professional will influence departmental strategy, make decisions on complex technical approaches for project components, and work autonomously with considerable latitude in determining objectives and approaches.

NOTE:

This is a work-from-home position requiring some travel to provider offices in and around the Peoria to Phoenix areas, but the majority of the work is performed from home.

• Travel consisting of monthly provider visits, with occasional quarterly travel to Las Vegas for team meetings.
• Distribute the Census Management Report (Admits / Discharges) to each practice.
• Monitor issues and action items in MSO Connect (membership, payment, contract load).
• Email inbox management.
• Follow‑up on existing action items and outreach management.
• Research and respond to MSO Member grievances from providers.
• Facilitate resolution of provider escalations or concerns, coordinating with internal departments as needed.
• Evaluate Data Hub for quality management, cost and utilization, develop interventions, and evaluate provider workflows.
• Attend team meetings, external meetings, and shared service partner collaboration meetings.

• Bachelor's Degree.
• Five or more years of experience in healthcare or managed care in provider contracting, network management, or provider relations.
• Some travel to provider offices in and around the Peoria to Phoenix areas is required; the role is largely remote.
• Ability to work independently and under minimal supervision.
• Prior healthcare consulting experience is required; a strong, knowledgeable provider engagement professional preferably in the managed care space (Medicaid/Medicare).
• Proven planning, preparation, and presentation skills, with established knowledge of reimbursement and bonus methodologies.
• Demonstrated ability to manage multiple projects and meet deadlines.

• Master's Degree.
• Candidate who works/live in Arizona is preferred.
• Proficiency in analyzing and interpreting financial trends for healthcare costs, administrative expenses, and quality/bonus performance.
• Comprehensive knowledge of Medicare policies, processes, and procedures.

Humana values personal identity protection. Applicants may be asked to provide their Social Security Number if it is not already on file. When required, an email will be sent from  with instructions to add the information to the official application on Humana’s secure website.

As part of our hiring process for this opportunity, we will be using Hire Vue, an interviewing technology that enables us to quickly connect and gain valuable information about your relevant skills and experience at a time that fits your schedule.

• Health benefits effective day 1.
• Paid time off, holidays, volunteer time, and 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 (NRGs).
• Career development opportunities.
• Travel:
  While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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The compensation range below reflects a good‑faith estimate of…