Hybrid Director, Provider Engagement

at Humana

• Job title: Director, Provider Engagement
• Job type: Full Time
• Experience level: Lead
• Salary: $138,900 - $191,000 per year
• Degree requirement: Postgraduate Degree
• Location requirements: Hybrid, United States

About the role

• Director of Provider Engagement enhancing relationships and performance metrics with healthcare providers and health plans. Leading strategic partnerships to improve financial and quality outcomes.

Responsibilities

• 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.

Requirements

• 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.

Benefits

• 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