Humana Provider Engagement Manager in Minnetonka, Minnesota

Role: Provider Engagement Manager

*Assignment: *Senior Products Market Management

*Location: *Minnetonka, MN

Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.

Assignment Capsule:

Be a part of the Market Operations world as a Provider Engagement Manager (PEM) – in this role you will manage the Provider Engagement staff. You will partner with the Provider Engagement Director to lead and manage the development of Humana’s overall provider relationships within a geographic region. Have the opportunity to drive strategic initiatives within the provider network and ensure that the alignment of departmental objectives is congruent with the overall business strategy.

Humana is seeking a Provider Engagement Manager who will have responsibility for managing a team of professionals while being a highly strategic partner for our market. The role will facilitate & provide detailed analysis, reporting, training, education and support to the Provider Engagement Executives and Consultants within their markets. This role will concentrate on people development, performance, compliance, and recruiting. As a PEM you will be instrumental in developing strong talent to build needed relationships with our providers.

· Management of staff including performance, compliance, recruiting

· Drive strategy for a single market with a team of highly trained professionals

  • Maximize opportunities to meet the P&L goals for engaged groups by managing provider performance and progression down path to value, for improvement in clinical and business outcomes. Represent the view of risk groups in developing bid strategies.
  • Manage the team to engage the business offices in annual strategy planning and follow up, and align market goals with corporate and regional strategy and drive these goals into the practice leveraging clinical resources
  • Identify promising providers to move along path to value and executing strategy to achieve goals to develop these providers
  • Monitor and share company, market and provider-specific metric reports for improvement opportunities
  • Develop and execute shared strategy with MarketPoint to grow profitable market share with engaged providers
  • Contribute to execution of market outreach activities
  • Develop and execute strategy customized to the needs of the engaged provider
  • Manage and deliver reporting and analysis on profitability and performance for internal and external entities on Provider groups
  • Perform and/or collaborate with Finance on analysis of trend issues, cost savings opportunities, utilization patterns, and other analysis as needed on Provider groups
  • Make recommendations to market leadership through detailed analysis/consideration of development issues, hi-potential risks, talent succession plans, and compliance with all associate development
  • Partner to help drive your talent to implement various initiatives with groups (HEDIS, MRA, STARS, etc.)

Role Essentials: * Bachelor's Degree * Management experience, associate development, with strong leadership capabilities * Health care or managed care with Provider Contracting, Network Management or Provider Relations experience * Demonstrated ability to manage multiple projects and meet deadlines * Comprehensive knowledge of Microsoft Office (PowerPoint, Excel)
* Ability to travel as needed

Role Desirables: * Strong grasp of financial and clinical acumen is optimal. * Strategic and functional execution with strategic business acumen including developing business or operating models to enable provider effectiveness. * Demonstrated ability to develop a competitive strategy, with financial and clinical acumen optimal. * Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies * Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance * Comprehensive knowledge of Medicare policies, processes and procedures

Additional Information

This role reports to the Market Director. It will require occasional overnight travel.

At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.

Title: Provider Engagement Manager

Location: Minnesota-Minnetonka

Requisition ID: 179082