Humana Provider Engagement Executive - NYC in New York, New York

*Role: *Provider Engagement Executive

*Assignment: *Market Management

*Location: *New York City, NY

Humana needs your skills to help us tell a compelling story about healthcare today with our Primary Care Providers across all lines of business. You will be the defined point of contact for PCPs and responsible for the financial performance of PCPs and IDSes. You will be successful by creating strategic partnerships with providers to improve health efficacy and efficiency and manage provider groups to collective quality and P&L results and goals. We’re looking for driven, innovative people who are interested in using their data-mining and analytical skills to help our providers and ultimately our members to achieve lifelong well-being and help Humana make lasting, positive changes in the healthcare industry.

Assignment Capsule Be a part of the Market Operations world as a Provider Engagement Executive, PEX – Create strategic provider partnerships with large, engaged providers to improve their experience with Humana. You will manage provider groups to enhance quality and P&L results and goals. Be a strong partner and build relationships with internal stakeholders to create a seamless experience for the provider.

Humana is seeking a Strategic Consultant who will use discipline and expertise to influence, lead and educate people and groups in order to optimize Market Operations results.

  • You will initiate, plan, and frame-up needed process improvements and establish requirements while consulting and gaining commitment from all key stakeholders.
  • Design and execute profitable growth strategies
  • Develop and/or implement processes and data sharing structure for delegated relationships
  • Strong facilitation skills with an ability to run provider meetings (JOC or PCP meeting) with prioritized specific topic agenda reflecting entire provider support organization
  • Develop and review Dashboard Metrics (quality, financial, triple AIM) and translate into actionable items based on group specifics
  • Ability to train others to use the tools that will make the PCP successful
  • Facilitate clinical education, leveraging clinical experience from your internal partners
  • Ability to provide actionable financial and operational data, and ensure action plans are implemented to achieve performance goals
  • Be the defined point of contact for the provider and communication according to group agreements. Manage all encounters with delegated providers
  • Identify and manage optimal grouping among non-risk providers to achieve higher performance and support provider experience
  • Manage provider continuum, prospecting other providers for value based opportunities
  • Influence provider culture and strategy to elevate capability of the provider community to support the ever changing healthcare environment.
  • Work to improve EMR capability
  • Partner with the provider and the company to develop capability for sustained, integrated consumer interaction programs building consumer and customer advocacy and loyalty.
  • Possess a deep understanding of segmentation and/or market segment opportunity, product development and product positioning; able to direct the implementation activities for a team of stakeholders.

Role Essentials

  • Bachelor’s degree
  • 5 years of progressive experience working in managed care
  • Understanding of STARS and HEDIS measures
  • Experience in implementing strategy to support value-based provider agreements
  • Strategic thinking and planning capabilities; organized and detail-oriented
  • Working knowledge of MS Word, Excel (pivot tables, bars/graphs, etc.) and PowerPoint
  • Excellent written and verbal communication skills
  • Excellent relationship building skills with both internal and external partners with ability to partner with senior leadership
  • Enthusiasm and motivation essential; a confident change-agent; strong selling and presentation skills (oral and written)
  • Willingness to manage and prioritize diverse projects
  • Business and financial acumen in the health care field.
  • Marketing and communications skills are optimal
  • Valid driver's license and reliable transportation with ability and willingness to travel around the region up to 50% of the time.

Role Desirables

  • Graduate degree preferred
  • Clinical/RN background
  • Knowledge of Humana’s internal policies, procedures and systems Additional Information 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.

After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.

Title: Provider Engagement Executive - NYC

Location: New York-New York

Requisition ID: 180261

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.