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Senior Provider Engagement Professional - New Orleans LA
Company name
Humana Inc.
Location
Metairie, LA, United States
Employment Type
Full-Time
Posted on
Dec 01, 2020
Profile
Description
The Senior 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 Senior Provider Engagement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
Responsibilities
The Senior 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. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Required Qualifications
5 years of Health care or managed care
Understanding of Provider Contracting, Network Management or Provider Relations experience
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Experience working with providers within the region (Louisiana/Mississippi)
Experience working with HEDIS and/or Stars measures
Understanding of Medicare Risk Adjustment
Demonstrated ability to manage multiple projects and meet deadlines
Preferred Qualifications
Bachelor'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
Understanding of Humana's internal processes and programs
Additional Information
This position is remote, however, you should be located in, or bordering, the State of Louisiana, in order to be considered for this role
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com
Location : New Orleans, LA
Location : New Orleans, LA
Location : New Orleans, LA
Description
Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we... 
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