About The Position

Become a part of our caring community and help us put health first The Provider Engagement Executive 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 Executive works on problems of diverse scope and complexity ranging from moderate to substantial. The Provider Engagement Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision. Uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact

Requirements

  • Bachelor's Degree and/or equivalent experience
  • Skilled in analyzing account performance, identifying trends, risks, and opportunities to drive continuous improvement and deliver measurable value.
  • Proven experience in relationship and account management, with a track record of building strong, trust‑based partnerships across diverse stakeholders.
  • 2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
  • Demonstrated ability to manage multiple projects and meet deadlines
  • Comprehensive knowledge of all Microsoft Office applications
  • Ability to travel approximately 20% as needed
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • 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. Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

  • 8 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
  • Candidates to reside in Washington or Oregon preferred
  • 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

Benefits

  • Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
  • Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
  • Among our benefits, Humana provides 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.

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What This Job Offers

Job Type

Full-time

Career Level

Executive

Number of Employees

5,001-10,000 employees

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