Medicaid Provider Services and Experience Senior Professional

Profile

Description

The Medicaid Provider Services and Experience Senior Professional is accountable for supporting strategy and execution on Humana's Medicaid provider support model. This position partners cross-functionally on matters of significance to develop the processes and tools to best serve Medicaid providers and drive optimal provider experience. This senior professional requires an in-depth understanding of provider relations, provider education, quality improvement, and/or value-based payment performance improvement. This role requires critical thinking/problem solving skills, cross functional collaboration, subject-matter expertise, a strategic mindset, and attention to detail.

Responsibilities

Job Description

Contribute to and develop Humana provider services strategy to drive optimal provider experience and performance in alignment with organizational goals

Support the development of provider services functions, including provider relations, claims education, and provider engagement, with an emphasis on creating and implementing standards, resources, tools and best practices sharing across the organization

Drive development of operational processes, trainings, and KPIs to execute on the Medicaid Provider Journey, Provider Relationship Management model, and other strategic initiatives

Partner cross-functionally among business partners to drive new processes or process improvements

Aid efficient and effective rollout of provider services models and strategies in Medicaid markets; tailor models and strategies to meet regulatory, contractual and/or local nuances of each Medicaid market

Required Qualifications

Bachelor's degree

3 years of experience in a provider facing role with a health plan, such as provider relations or value-based payment performance

3 years of leading or supporting projects requiring synthesis and evaluation of multiple sources of qualitative and quantitative data to define priorities and build solutions

Ability to identify, prioritize, and solve complex business problems

Strong attention to detail

Experience operating in matrixed environment

Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partners

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications

Master's Degree in Business, Public Health or related field

Understanding of and/or experience in Medicaid provider services

Prior experience working with behavioral health, long-term services and supports and/or home (LTSS) and community based services providers, either at the plan or provider level

Additional Information

Business hours will be EST

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com