Director of Provider Engagement

The Director, Provider Engagement leads a team of Provider Engagement associates responsible for developing and strengthening positive, long-term relationships with contracted physicians, provider groups, health systems, and ancillary providers across Humana's Medicare Advantage network. You drive provider engagement strategies focused on improving provider experience, quality outcomes, Star Ratings performance, value-based care adoption, risk adjustment performance, and operational excellence. You will report to the VP, Network Performance.

You will serve as a key market leader, representing Provider Engagement across cross-functional initiatives and ensuring alignment between provider needs and Humana's strategic priorities.
* Lead, develop, and support a team of up to 13 Provider Engagement associates responsible for managing relationships with contracted providers and healthcare organizations.
* Establish team strategy, operating processes, and performance expectations aligned with organizational objectives.
* Conduct regular performance evaluations and provide coaching, mentoring, and professional development opportunities.
* Foster a culture of accountability, collaboration, continuous improvement, and provider-centric engagement.
* Monitor performance against established key performance indicators and organizational goals.
* Build and sustain strong relationships with value-based provider partners.
* Represent Humana at key provider meetings, association events, market forums, and strategic provider discussions.
* Develop and execute provider engagement strategies that support Medicare Star Ratings improvement and quality performance objectives.
* Partner with provider organizations to drive performance within value-based payment arrangements and alternative payment models.
* Utilize claims, quality, risk adjustment, utilization, and provider performance data to identify trends, barriers, and opportunities for improvement.
* Provide leadership visibility into provider trends, emerging risks, barriers, and opportunities impacting market performance.
* Ensure accurate tracking and reporting of provider engagement activities, strategic initiatives, and performance results.#
** Use your skills to make an impact
**** Required Qualifications
*** 7+ years of experience in managed care, provider relations, healthcare operations, quality improvement, value-based care, or related healthcare leadership roles
* 5+ years of people leadership experience, including leading teams and developing talent
* Experience working with provider groups, health systems, and healthcare organizations
* Knowledge of Medicare Advantage operations, provider performance management, and healthcare delivery systems
* Comprehensive knowledge of CMS Star Ratings, HEDIS, CAHPS, and risk adjustment
* Experience using data and analytics to identify performance opportunities and influence operational outcomes
* Experience presenting to leadership
* Experience with Excel and PowerPoint
* ** Ability to travel 25% within assigned market geography*
* ** Preferred Qualifications
*** Degree in Healthcare Administration, Business Administration, Public Health, or related field
* Knowledge of Medicaid regulatory requirements
* Demonstrated strategic planning and project execution capabilities  
** Additional Information
**** Requires travel up to 25%
** Work at Home Requirements:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
** Scheduled Weekly Hours
** 40
* * Pay Range
** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education,…