Manager, Provider Engagement

Become a part of our caring community and help us put health first

The Manager, 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 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 Relations HIDE SNP, leads a team of provider relations associates responsible for growing positive, long‑term relationships with network PCP/Medical, behavioral health and Long‑Term Services and Support (LTSS) providers in Humana’s Dual Integrated (HMO D‑SNP) in Michigan plan through day‑to‑day, front‑line relationship management. The Manager is responsible for facilitating a positive provider relationship management experience, through provider training, education, responding to provider inquiries, and resolving issues or complaints.

Understands key internal systems that support the provider experience. This individual identifies and leads opportunities to make changes to improve operations across teams and works on general matters in which analysis of issues, data and processes require evaluation of multiple factors.

• The applicant must be located in MI or willing to relocate to the Metro Detroit area.
• Ability to travel as needed throughout Michigan
• Bachelor’s Degree with 4 or more years of progressive experience in managed care operations, including network management and provider relations OR High School Diploma with 7 or more years of progressive experience in managed care operations, including network management and provider relations.
• Experience working for or with key provider types (such as primary care, FQHCs, hospitals, nursing facilities, and/or HCBS and LTSS providers).
• 2+ years of management and team building experience including supervising a staff of at least 5-10 employees.
• Prior experience working in and strong understanding of Medicare and Medicaid /HIDE DSNP
• Proven planning, preparation and presenting skills.
• Demonstrated ability to manage multiple projects and meet deadlines.
• Exceptional relationship management skills.
• Ability to manage multiple priorities in a fast‑paced environment.
• Knowledge of Microsoft Office applications.

• Master’s Degree.
• Experience in and/or understanding of Michigan’s Dual Integrated (HMO D‑SNP) provider landscape and networks.
• Contract negotiation and implementation experience.

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self‑provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• 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.

As part of our hiring process for this opportunity, we will be using an interviewing technology called Hire Vue to enhance our hiring and decision‑making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

• Assessment: If you are selected to move forward, you will receive a text and/or e‑mail to complete the assessment.
• Video Prescreen: If you are successful with your text screen, you will receive another communication to record a Video Prescreen. This is an online video activity using your phone, tablet, or computer; however, most candidates prefer using a computer…