[Hiring] Provider Engagement Professional @CenterWell

Role Description

The Provider Engagement Professional 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. You will work assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action. You will report to the Director, Provider Engagement.

• Represent the scope of health plan/provider relationship across various areas, including:
  • Financial performance
  • Incentive programs
  • Quality and clinical management
  • Population health
  • Data sharing
  • Connectivity
  • Documentation and coding
  • HEDIS and STARs performance
  • Operational improvements
• Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Qualifications

• Bachelor's Degree.
• 1-5 years of health care or managed care experience with Provider Contracting, Network Management, or Provider Relations.
• Experience working with service fund reports.
• 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.

Requirements

• This is a remote position working out of your home office that will include travel to provider offices approximately 3-4 days/week.
• Work at Home Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps is required; wireless, wired cable, or DSL connection is suggested.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Competitive benefits that support whole-person well-being.
• 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.

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.

• $59,300 - $80,900 per year
• This job is eligible for a bonus incentive plan based upon company and/or individual performance.