The Associate Director, Provider Engagement 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 Associate Director, Provider Engagement requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Provider Engagement represents the scope of health plan/provider relationship across Provider Payment Integrity, which includes such areas as financial performance, data sharing, connectivity, documentation and coding, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. This role is heavily engaged in resolving complex technical and operational problems, leveraging data and resources across the organization, influencing strategy and driving change, and leading multiple managers and highly specialized professional associates.
5+ years of management experience leading a high performing team
5+ years of experience in contracting, network management or provider relations
Significant knowledge of reimbursement practices within a health payer environment
Proven strategic planning and consultative skills, and engagement with senior leadership
Business acumen and financial acuity with ability to assess and respond to unique market and provider needs
Excellent communication skills with experience delivering complex concepts to all levels
Able to build sustaining relationships and leverage matrix resources
Demonstrated ability to manage multiple projects and meet deadlines
Proven negotiation skills
Comprehensive knowledge of all Microsoft Office applications
Ability to travel as needed
Nice to Have
Practical experience with provider payment integrity concepts
Proficiency in analyzing and interpreting financial trends for health care costs
Comprehensive knowledge of Medicare and/or Medicaid policies, processes, and procedures
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms -when and where they need it. Our employees are at the heart of making this happen and that's why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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