HumanaHU

Provider Engagement Professional 2

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky, offering a wide range of insurance products and health and wellness services.

Humana

Employee count: 5000+

Salary: 59k-81k USD

United States only

Become a part of our caring community and help us put health first

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.

The Provider Engagement Professional 2 represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs 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. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.


Use your skills to make an impact

Required Qualifications

  • Must reside in the state of Florida in one of the following counties: Gulf, Liberty, Franklin, Gadsden, Wakulla, Leon, Jefferson, Madison, or Taylor
  • 80% travel required for this position
  • Bachelor's Degree
  • 1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
  • Demonstrated ability to manage multiple projects and meet deadlines
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Master's Degree
  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
  • Comprehensive knowledge of Medicare policies, processes and procedures

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$59,300 - $80,900 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

About the job

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Job type

Full Time

Experience level

Mid-level

Salary

Salary: 59k-81k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Humana

Learn more about Humana and their company culture.

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Humana Inc. is dedicated to improving the health and well-being of the millions of people it serves. Our customers often navigate complex healthcare systems and face challenges in accessing affordable, high-quality care. That's why we are committed to putting health first, not just for our members, but also for our teammates and the broader communities we impact. We understand that true health encompasses more than just physical well-being; it includes emotional, social, and financial health. Therefore, we strive to offer personalized care from people who genuinely care, listening to our members' needs and creating solutions that help them achieve their best selves. Our approach is rooted in an integrated care delivery model that aims to simplify the healthcare experience, making it easier for individuals and families to get the right care at the right time.

Since our founding in 1961, initially as a nursing home company and later evolving into a leading health insurance provider, Humana has consistently adapted to meet the changing needs of the healthcare landscape. We specialize in government-sponsored programs, with a significant portion of our medical membership stemming from Medicare Advantage, Medicaid, and TRICARE. Beyond traditional insurance, Humana is increasingly focused on providing comprehensive healthcare services, including primary care, at-home care, and pharmacy benefit management through our CenterWell brand. We recognize that many of our customers, particularly seniors, are managing multiple chronic conditions. Our integrated care delivery model, which leverages both high-tech tools like data analytics and personalized, low-tech interactions such as in-home visits, allows us to predict, slow, and sometimes even prevent disease progression. We are deeply invested in the communities we serve, working to address health disparities and improve local health outcomes through initiatives like our Bold Goal, which aims to improve the health of the communities we serve by making it easier for people to achieve their best health.

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Humana hiring Provider Engagement Professional 2 • Remote (Work from Home) | Himalayas