Role: Health Systems Manager
Assignment: Humana Government Business
Location: Langley AFB, VA (Hampton, VA area)
We’re looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our consumers, providers, employers, agents and others we work with.
At Humana, Perfect Service® means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our members, employers, providers, and colleagues. We’re looking for people who improve their own well-being by looking out for the best interests of others.
Oversees the implementation and operations of the TRICARE contract in smaller multi-city geographic areas. Generally has multiple Humana Contract Offices (HCOs) under their supervision and responsibility for multiple Plan Areas. Responsibility for financial performance under the contract, MHS optimization efforts and improving contract incentive performance. Supervises Health Systems Consultants, Provider Education Relations Representatives and Managed Care Support Liaisons and overall operation of the HCOs. Responsible for network management to include network adequacy, access to care standards, provider relations and provider management over multiple Prime Service Areas and Transitional Prime Service Areas (TPSAs). Responsible for creating and maintaining high performing networks throughout the PSAs with a focus on improving steerage to the best quality providers while adhering to the government Quadruple Aim construct. Ensure contractual compliance, coordinate and direct the efforts of HCO and WAH staff to optimize results. Responsible for maintaining good working relationships and m aintaining communication as the primary point of contact with Military Treatment Facilities, Commanders and their staffs within assigned PSA. Coach and develop associates to improve performance and prepare for future positions.
Working knowledge of a PC office suite including presentation and spreadsheet software
Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing). Role Desirables
Managed Care experience desirable
Title: Health Systems Manager (Langley AFB - Hampton, VA area)
Location: Virginia-Glen Allen
Other Locations: US-Virginia-Hampton
Requisition ID: 169256
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.