Provider Engagement Professional 2
Humana

Job Info

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Description

The Provider Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Provider Engagement Professional 2 represents the scope of health plan/provider relationship across such areas as financial performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. This role will be responsible for maintaining strong provider relationships and ensuring provider satisfaction through the resolution of claims and service related concerns. Continual education to providers is a key responsibility of this role.

Required Qualifications

• 2-3 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
• Proven planning, preparation and presenting skills
• Knowledge of healthcare claims processing
• Demonstrated ability to manage multiple projects and meet deadlines
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Valid driver's license with reliable transportation and the ability and willingness to travel to provider offices within the region up to 50% of the time

Preferred Qualifications

• Bachelor's Degree
• Comprehensive knowledge of Medicaid policies, processes and procedures

Additional Information

This role is considered "remote/work at home", however, you must live within the State of Kentucky to be considered for this position and will be required to travel to provider offices within the Southeastern region of the State.

Scheduled Weekly Hours

40

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