Role: *Provider Engagement Consultant *Assignment: *Market Management *Location:Southfield, MI
Humana needs your analytical skills to help us tell a compelling story about healthcare today. Through the strategic interpretation of data, we provide our consumers with meaningful insights about the choices they make and help them lead their best lives. We’re passionate about combining and analyzing diverse types of data to extract new, actionable discoveries about our members and their health-related behaviors. We encourage you to dive into your passion for data and use analysis to help Humana tell the health-and-wellness stories of our members. We’re looking for driven, innovative people who are interested in using their data-mining and analytical skills to help our consumers achieve lifelong well-being and help Humana make lasting, positive changes in the healthcare industry.
Be a part of the Market Operations world – Connect with providers and expand future opportunity.
Humana is seeking a Provider Engagement Consultant who will develop and maintain key relationships; works with assigned area to optimize business results. Manage provider groups to achieve quality and P&L goals. Create strategic provider partnerships to improve health efficiencies, and foster provider experience while ensuring cohesion across product lines. Create strategic provider partnerships with path to value providers to improve their experience with Humana. Be a strong partner and build relationships with internal stakeholders to create a seamless experience for the provider. * Design and execute profitable growth strategies * Develop and/or implement processes and data sharing structure for assigned providers * 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 * Create spreadsheet forecasting models and develop database tools to assist senior management in provider/customer negotiations, to measure growth and monitor profitability * 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 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. * Work in a consultative role with various departments locally and at corporate headquarters in creating effective information and analyses in order to optimize the market’s strategic objectives.
Role Essentials * Bachelor’s Degree * Prior experience in a fast paced insurance or health care setting * Advanced knowledge of HEDIS measures * Computer literate (MS Word, Power Point, Excel). * Proven analytical skills with the ability to communicate financials * Excellent communication skills, both oral and written * Strong relationship building skills
Role Desirables * Graduate degree preferred * Knowledge of Humana’s internal policies, procedures and systems.
You will report to the Provider Engagement Director or Manager. This area is under the leadership of the SVP & Chief Operating Officer.
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 Consultant
Requisition ID: 192503
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.