Provider Engagement Professional

Overview

Become a part of our caring community and help us put health first

The Provider Engagement Professional 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 Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Provider Engagement Professional 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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

• Seeking Gulf Coast candidates (preferably located in the following counties: Lee, Collier, Charlotte, Sarasota, and/or Manatee)

• A minimum of three experience in Healthcare 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
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance

• Bachelor's Degree
• Comprehensive knowledge of Medicare policies, processes and procedures
• Value based care knowledge

• Remote role
• 50% local travel between clinics; mileage reimbursement will be issued

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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$59,300 - $80,900 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits include medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Center Well Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well‑being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes.

We go beyond physical health by also addressing other factors that can impact a patient’s well‑being.

Center Well creates experiences that put patients at the center. As the nation’s largest provider of senior‑focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, Center Well is focused on whole‑person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), Center Well offers stability, industry‑leading benefits, and…