Humana Provider Engagement Executive in Federal Way, Washington

Role: *Provider Engagement Executive – PEX *Location:Federal Way, WA

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 – Partner with the Provider Engagement Director to 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.

  • Partner to design and execute profitable growth strategies

  • Gain intimate understanding of the groups’ strategies and find new intervention opportunities for Humana to support the groups’ objectives

  • 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

  • Utilize available metrics and reports (quality, financial, triple AIM) and translate into actionable items based on group specifics

  • Ability to train others to use the tools that will enable the PCP to be successful

  • Partner and leverage knowledge from all internal partners

  • Create spreadsheet forecasting models and develop database tools to assist senior management in provider/customer negotiations, to measure growth and monitor profitability

  • Be the defined point of contact for the provider and communication according to group agreements. Manage all encounters with delegated providers

  • Work to improve EMR capability

  • 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 strongly preferred

  • Deep understanding of strategic planning, direct response marketing, customer/provider loyalty and retention programs, and primary and secondary research processes

  • Strategic thinking and planning capabilities; organized and detail-oriented

  • Strong database software proficiency

  • Excellent written and verbal communication skills

  • Excellent relationship building skills with both internal and external partners

  • Enthusiasm and motivation essential; a confident change-agent; strong selling and presentation skills (oral and written)

  • Abilityto manage and prioritize diverse projects

  • Business and financial acumen in the health care field. Marketing and communications skills are optimal

  • This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

    Role Desirables

  • Graduate degree preferred

  • Experience working with prominent provider groups

  • Knowledge of Humana’s internal policies, procedures and systems

  • Prior successful large account management.

    Reporting Relationships You will report to a Provider Engagement Director or Manager.

    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.


Title: Provider Engagement Executive

Location: Washington-Federal Way

Requisition ID: 192862

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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.