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The Director, Provider Engagement 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 Director, Provider Engagement requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This role will report to the National President, MSO Operations.

The Director, Provider Engagement 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. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy.

The incumbent must reside in Kentucky, Tennessee, Georgia, North Carolina or Virgina

Responsibilities

Manage market engagement teams to drive outcomes to achieving all revenue and quality/clinical performance targets.
Drive a consistent service experience with the MSO across the engagement lifecycle, from first communication with the practice.
Lead the affiliate market team with an eye to develop and maintain a strong team culture, uphold company values and create strong team engagement.
Guide the team in developing individual practice action plans to optimize performance and operations.
Cultivate in-depth relationships with practices and regional partners through regular status calls and in-person meetings to set priorities, report performance results, monitor utilization and costs and identify opportunities for growth and savings.
Lead the on-boarding and implementation of new practices and plan for success.
Partner with MSO growth leadership to support local expansion of the affiliate network with a strong service offering to all customer segments.
Serve as a bridge between the market team and MSO leadership to communicate concerns, needs and feedback.
Provide regular performance reporting to MSO Operations leadership
Achieve high partner practice retention and satisfaction
Perform other duties and special projects as requested by the leadership team.

Use your skills to make an impact

Required Qualifications

Master's Degree
8 or more years Provider Contracting
5 or more years of management experience
Strong relationship building skills
Excellent communication skills, both oral and written
Comprehensive knowledge of all Microsoft Office applications
Ability to travel as needed
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Prior work experience in the health solutions industry with demonstrated success directing and leading teams
Proficiency in quality improvement processes, analyzing and interpreting financial trends

Additional Information

Requires 50% local and 50% regional travel

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, certifications, etc.

$138,900 - $191,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About CenterWell Senior Primary Care: CenterWell 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.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Full Time Jobs in Hamilton, IL

Director, Provider Engagement [Southeast]

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