Director, Provider Engagement

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

The Director, Provider Engagement develops and grows positive, long-term relationships with physicians, providers, and healthcare systems. These relationships intend to support financial and quality performance within the contracted working relationship with the health plan. The Director, Provider Engagement requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

You will:

• Lead strategic relationships between the health plan and providers, focusing on financial performance, incentive programs, quality improvement, clinical management, and population health programs.
• Oversee and guide enhancements in data sharing, connectivity, documentation, coding accuracy, HEDIS and STARs performance, and operational processes to improve provider outcomes and member experience.
• Implement new or updated programs and large-scale projects, ensuring understanding of technical and operational procedures for execution.
• Develop strategic plans to support market growth, provider satisfaction.
• Provide informed input into functional strategy, contributing to organizational goals and performance improvement.
• Collaborate with all partners to foster provider engagement and deliver measurable improvements across all main performance areas.

Use your skills to make an impact
 

Required Qualifications

• Master's degree from an accredited institution.
• Minimum of 8 years of experience in provider contracting or a related field.
• At least 5 years of proven management experience, demonstrating leadership and team development skills.
• 5 years of direct experience working with Louisiana Medicaid programs, including familiarity with relevant policies and regulations.
• Demonstrated relationship-building skills, with a proven ability to establish and strengthen partnerships with providers and stakeholders through effective verbal and written communication of complex information.
• Demonstrated ability to proficiently utilize Microsoft Office applications—including Word, Excel, PowerPoint, Teams, and Outlook—for preparing reports, conducting analyses, and delivering effective presentations.
• Willingness to travel up to 25% of the time to meet our needs.
• Residency within the state of Louisiana is mandatory.

Preferred Qualifications

• Prior work experience in the health solutions industry with demonstrated success directing and leading teams
• Proficiency in quality improvement processes, analyzing and interpreting financial trends

Driving Statement

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher

Work-At-Home Requirements

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

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is required.
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates 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 associates 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

Workstyle: Combination remote work at home and onsite/provider office/conferences

Hours: We require you to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, with flexibility for business needs.

Travel: Requires 25% travel within Louisiana to the Market office, Providers office and Provider conferences

Additional Information

Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)

Interview Format

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

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.

 

$138,900 - $191,000 per year

 

This 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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.