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Description

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 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

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.

**Hybrid Workstyle; allowing work from home 3 days per week and travel to clinics 2 days per week; on average.

Required Qualifications

  • 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

Preferred Qualifications

  • Bachelor's Degree

  • Comprehensive knowledge of Medicare policies, processes and procedures

  • Value based care knowledge

Additional Information

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

  • Incumbent must be based in Las Vegas area.

  • Hybrid Workstyle; allowing work from home 3 days per week and travel to clinics 2 days per week; on average.

Scheduled Weekly Hours

40



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Our Hiring Process

Apply online

To be considered for a job, you must apply online. Unfortunately, we cannot accept resumes that have been emailed to us. Once you find a job that interests you, simply select “Apply.” It typically takes 15 minutes to fill out the application form. Be sure to update your resume and upload it as you cannot edit the resume or add it after the application has been submitted. Shortly after you submit your application, you will receive a confirmation.

Next Step

If selected to continue with the interview process, you will be contacted through text or email to complete an assessment or schedule an initial live or recorded phone or video interview.

A hiring manager interview

After hiring managers and interview teams carefully consider the skills and experiences of applicants, they contact the top candidates via email or phone to schedule an interview.

Offer from Humana

If you’ve successfully completed the interview process and are identified as the candidate we would like to hire, you will receive an offer from our Talent Acquisition team.

Onboarding

If you accept the offer to join our Humana team, you will receive a welcome call or email to begin the onboarding process.


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Hiring Process