Role: Provider Engagement Consultant Assignment: Sr. Medicare Products Location: Lafayette, LA WAH
Assignment Capsule Humana is seeking a Provider Engagement Consultant who will develop and maintain key relationships; works with assigned area to optimize business results. * Utilizes clinical research from Clinical Resource to develop actionable items based on group specifics.
Leads collaboration with supporting roles to develop strategy for non-Value Based Reimbursement (VBR) groups
Facilitates provider meetings (with office manager or Primary Care Physician) with prioritized specific topic agenda reflecting department in supporting roles
Facilitates utilization of virtual Medicare Risk Adjustment education and coding education based on group’s most recent chart retrieval findings.
Collaborates with clinical supporting roles, Provider Engagement Manager, and Stars Leader to maximize STARS score (including closure of HEDIS gaps, CAHPS/HOS education, annual wellness / annual physical completion, and coordination In-home Assessments with PCPs)
Develop and review Metrics (quality, financial, triple AIM, etc.) and translate into actionable items based on group specific.
Conduct monthly strategy meetings with internal partners (i.e. clinical, finance, MRA, Stars).
Recommends connectivity strategy (including EMR, supplemental data and lab feeds) for each group and collaborates to execute mandatory corporate initiatives
Provide actionable financial and operational data, and ensure action plans are implemented to achieve performance goals
Role Essentials * Bachelor’s Degree
Proficient in Microsoft Office
Excellent communication skills, both oral and written
Strong relationship building skills
Self-starter, ability to work independently
Must reside in Layfayette, LA or within a commutable distance
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
Working knowledge of Medicare
Reporting Relationships You will report to Market Manager. This area is under the leadership of the SVP & Chief Operating Officer.
Additional Information *This is a provider facing role with day 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 Consultant
Other Locations: US-Louisiana-New Orleans, US-Louisiana-Baton Rouge
Requisition ID: 191561
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.