What are the responsibilities and job description for the Director, Provider Engagement position at Humana?
Become a part of our caring community and help us put health firstThe 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.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.Role OverviewOversees the development and implementation of contracting activities for our Long Term Care, ABA, and EIS network as well as the provider relations team.This role directs the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between health plan and vendors or providers as well as develops and implements provider education and training.This position designs and implements methods for improving provider satisfaction and strengthening provider relationships.Work with business development and providers to develop a strategy for developing new networks including plans to meet network access and unit cost objectives.Determine necessary resources to develop the network and assemble the appropriate team across all business functions.Responsible for a team of Contractors and Provider Relation Representatives.Use your skills to make an impactRequired QualificationsMaster's DegreePrior healthcare experiencePrevious managed care experience8 or more years Provider Contracting5 or more years of management experienceStrong relationship building skillsExcellent communication skills, both oral and writtenComprehensive knowledge of all Microsoft Office applicationsAbility to travel as neededMust be passionate about contributing to an organization focused on continuously improving consumer experiencesTravel is required for this positionPreferred QualificationsPrior work experience in the health solutions industry with demonstrated success directing and leading teamsProficiency in quality improvement processes, analyzing and interpreting financial trendsScheduled Weekly Hours40Pay RangeThe 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 BenefitsHumana, 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.About usHumana Inc. (NYSE : HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.Equal Opportunity EmployerIt 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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.#J-18808-Ljbffr
Salary : $138,900 - $191,000
