[Remote] Provider Engagement Professional - Seattle WA

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Humana is a leading health care company focused on improving health outcomes. The Provider Engagement Professional develops and maintains relationships with healthcare providers to enhance financial and quality performance within the health plan's network. Responsibilities Develops and grows positive, long-term relationships with physicians, providers and healthcare systems Supports and improves financial and quality performance within the contracted working relationship with the health plan Represents the scope of health plan/provider relationship across areas such 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 Skills Bachelor's Degree or equivalent experience 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 Value based care Data analysis experience Database care experience Experience with HEDIS/STARS MSO and Payor experience Must be highly service oriented Travel in and around State of Washington. Primarily around the Seattle, WA Metro area Must be passionate about contributing to an organization focused on continuously improving consumer experiences 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 Benefits Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities Medical, dental and vision benefits Short-term and long-term disability Life insurance Company Overview Humana is a health insurance provider for individuals, families, and businesses. It was founded in 1964, and is headquartered in Louisville, Kentucky, USA, with a workforce of 10001+ employees. Its website is
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

**Experienced Remote Data Entry Clerk - Home-Based Opportunity with Global Logistics Leader UPS**

Remote Full-time

Experienced Senior Data Scientist for Disney's Consumer Products, Gaming, and Publishing Group - Leading Data-Driven Insights and Strategic Decision Making Across Omni-Channel Platforms

Remote Full-time

Experienced Full Stack Software Engineer – Web & Cloud Application Development

Remote Full-time

Experienced Customer Service Operations Supervisor – Leadership and Strategic Management of Patient Access Support Teams

Remote Full-time

Experienced Customer Service Representative – Remote Work Opportunity with arenaflex, Delivering Exceptional Financial Solutions and Services

Remote Full-time

Remote Pilot Operator at the FAA Academy

Remote Full-time

Product Manager/Owner - Technology

Remote Full-time

Experienced Data Entry Specialist for Remote Work Opportunity in Healthcare Process Automation and Interoperability

Remote Full-time

IP Patent Agent Charlotte, Chicago, Dallas, Los Angeles Raleigh, San Francisco, Sili

Remote Full-time

**Experienced Data Entry Specialist – Remote Opportunity with arenaflex**

Remote Full-time
← Back to Home