Manager, Provider Engagement
DescriptionHumana Healthy Horizons in Indiana is seeking a Manager, Provider Engagement who develops and grows positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. The Manager, Provider Engagement works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.
The Manager, 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.
The Manager, Provider Engagement is responsible for:
· Decisions related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.
· Cross functional departmental collaboration.
· Conducting briefings and area meetings.
· Maintaining frequent contact with other managers across the department.
- Must reside in the state of Indiana.
- Bachelor's Degree.
- 6 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience.
- 2 or more years of demonstrated management experience and partnering with senior leadership on strategic initiatives.
- Comprehensive knowledge of Indiana State Medicaid policies and procedures.
- 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 as needed.
Work at Home Requirements
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Humana will provide Home or Hybrid Home/Office associates 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.
- Master’s degree.
- Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance.
- Passionate about contributing to an organization focused on continuously improving consumer experiences.
- Workstyle: Remote but may vary due to travel and occasional onsite work at the Humana Healthy Horizons office in Indiana.
- Travel: Up to 50% travel in the state of Indiana to provider offices and Humana locations.
- Core Workdays & Hours: Monday – Friday; typically 8:00am – 5:00pm Eastern Standard Time (EST)
- Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes; 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.....
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Social Security Task
#LI - Remote Indiana
Scheduled Weekly Hours40