Humana Specialty Provider Engagement Executive in Indianapolis, Indiana
The Specialty Provider Engagement Executive 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 Executive works on problems of diverse scope and complexity ranging from moderate to substantial.
The Specialty Provider Engagement Executive works with a variety of independent and hospital affiliated specialist groups, representing the scope of health plan/provider relationship. The Specialty Provider Engagement Executive will work across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing and operational improvements. The Specialty Provider Engagement Executive will work collaboratively with Humana corporate and market resources to specifically improve specialty provider performance, member experience, and operational excellence. The SPEX will work with specialty physician and practice leaders to develop functional strategies on matters of significance. The SPEX exercises independent judgment and decision making on complex issues regarding job duties and related tasks, works within a team under minimal supervision and uses independent judgment requiring analysis of variable factors in determining the best course of action.
5 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
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 up to 50% within the region
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
Understanding of Value based care
Clinical experience or background (RN, Pharmacy, etc)
Comprehensive knowledge of Medicare policies, processes and procedures
This position will be remote within the region (OH, MI, IN). As we return to normal operations, this person will be required to travel to provider offices within the region.
Scheduled Weekly Hours
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