Provider Engagement Executive - Knoxville​/Tri- TN

Provider Engagement Executive - Knoxville/Tri-Cities TN page is loaded## Provider Engagement Executive - Knoxville/Tri-Cities TN locations:
Remote Tennessee - Knoxville time type:
Full time posted on:
Posted Todayjob requisition :
R-397516#
** Become a part of our caring community and help us put health first
** The 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 Provider Engagement Executive 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. Advises executives to develop functional strategies (often segment specific) on matters of significance.

Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.#
** Use your skills to make an impact
**** Required Qualifications
*** 2 or more years of Health care or managed care with Provider Relations, Provider Contracting, or Network Management experience
* Minimum of 1 year of experience working with provider groups on HEDIS and/or Stars performance improvement
* Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
* Experience partnering with senior leadership on strategic initiatives
* Established knowledge of reimbursement and bonus methodologies
* Proven planning, preparation and presenting skills
* Demonstrated ability to manage multiple projects and meet deadlines
* Comprehensive knowledge of all Microsoft Office applications
* Must be located in Knoxville/Tri-Cities area with the ability to travel as needed within Gulf South Market (LA, MS, AL, TN)
** Preferred Qualifications
*** Bachelor's Degree
* Established provider relationships within the Gulf South Market
* Demonstrated project management experience
* Comprehensive knowledge of Medicare policies, processes and procedures
** Additional Information
** This role is "remote/work at home", however, you must be located within the Knoxville/Tri-Cities area with the ability to travel within the Gulf South region (TN, AL, MS, LA)
** Work at Home Information
** To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
* At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
* Satellite, cellular and microwave connection can be used only if approved by leadership.
* Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
* Humana will provide Home or Hybrid Home/Office employees 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.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
** Scheduled Weekly Hours
** 40
* * 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,…