Humana
Sr. Provider Engagement Professional – Humana
The DSNP Senior Provider Engagement Professional plays a critical role in managing operational processes, compliance activities, and provider engagement for the DSNP plans. The position ensures accurate program tracking, supports payer relationships, facilitates training and communication across internal and external stakeholders, and maintains smooth operations and compliance of the DSNP Health Home program. Key responsibilities include: tracking program activity, maintaining accurate policies and procedures, supporting payer partnerships through meeting coordination and presentation development, leading training efforts for internal teams and external stakeholders, managing system access for state platforms, overseeing compliance projects, updating provider manuals and websites, maintaining contact lists, handling data files, and providing backup support for program communications. The role also collaborates with partners to resolve plan issues, supports member communications, and provides support for Medicare/Medicaid and related program requirements.
Base Pay Range $71,100 - $97,800 per year
Required Qualifications
Bachelor’s degree, preferably in healthcare administration, public health, health informatics, social services, nursing, business administration or other related field.
3 years of experience in managed care, DSNP programs, health home operations, network management, provider relations, or work with state health agencies/community organizations.
In‑depth knowledge of CMS and state regulations for DSNP, Medicare/Medicaid, and related programs.
Strong organizational and communication skills with the ability to manage diverse stakeholders.
Skilled in planning, preparation, and delivering presentations with proven ability to handle multiple projects and meet deadlines with attention to detail.
Proficiency in healthcare systems and Microsoft Office Suite.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Master’s Degree, preferably in a healthcare‑related field.
Experience with project management tools and methodologies.
Advanced knowledge of CMS compliance audits and state regulatory processes.
Familiarity with payer relations and contract management.
Strong data analysis and reporting skills for program performance metrics.
Experience developing training programs and leading stakeholder education sessions.
Demonstrated ability to lead cross‑functional teams and drive process improvements.
Additional Information Work at Home / Internet Statement: Employees who work from home must have a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Satellite, cellular, and microwave connections may be used only if approved by leadership. Employees residing in California, Illinois, Montana, or South Dakota will receive a bi‑weekly payment for internet expenses. Humana will provide telephone equipment appropriate to the business requirements. Work must be conducted in a dedicated space that protects member PHI/HIPAA information.
Travel: While this position is remote, occasional travel to Humana's offices for training or meetings may be required.
Benefits Humana offers competitive benefits, including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off; short‑ and long‑term disability; life insurance; and additional opportunities to support whole‑person well‑being. The position is eligible for a bonus incentive plan based on company and individual performance.
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. Humana also takes affirmative action in accordance with Section 503 of the Rehabilitation Act and VEVRAA to employ and advance individuals with disability or protected veteran status, basing all employment decisions solely on valid job requirements.
Job Details Location: Remote (Tri‑state Region: Intermountain Region)
Employment Type: Full‑time
Seniority Level: Mid‑Senior
Application Deadline: 01‑09‑2026
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Base Pay Range $71,100 - $97,800 per year
Required Qualifications
Bachelor’s degree, preferably in healthcare administration, public health, health informatics, social services, nursing, business administration or other related field.
3 years of experience in managed care, DSNP programs, health home operations, network management, provider relations, or work with state health agencies/community organizations.
In‑depth knowledge of CMS and state regulations for DSNP, Medicare/Medicaid, and related programs.
Strong organizational and communication skills with the ability to manage diverse stakeholders.
Skilled in planning, preparation, and delivering presentations with proven ability to handle multiple projects and meet deadlines with attention to detail.
Proficiency in healthcare systems and Microsoft Office Suite.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Master’s Degree, preferably in a healthcare‑related field.
Experience with project management tools and methodologies.
Advanced knowledge of CMS compliance audits and state regulatory processes.
Familiarity with payer relations and contract management.
Strong data analysis and reporting skills for program performance metrics.
Experience developing training programs and leading stakeholder education sessions.
Demonstrated ability to lead cross‑functional teams and drive process improvements.
Additional Information Work at Home / Internet Statement: Employees who work from home must have a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Satellite, cellular, and microwave connections may be used only if approved by leadership. Employees residing in California, Illinois, Montana, or South Dakota will receive a bi‑weekly payment for internet expenses. Humana will provide telephone equipment appropriate to the business requirements. Work must be conducted in a dedicated space that protects member PHI/HIPAA information.
Travel: While this position is remote, occasional travel to Humana's offices for training or meetings may be required.
Benefits Humana offers competitive benefits, including medical, dental, and vision coverage; a 401(k) retirement savings plan; paid time off; short‑ and long‑term disability; life insurance; and additional opportunities to support whole‑person well‑being. The position is eligible for a bonus incentive plan based on company and individual performance.
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. Humana also takes affirmative action in accordance with Section 503 of the Rehabilitation Act and VEVRAA to employ and advance individuals with disability or protected veteran status, basing all employment decisions solely on valid job requirements.
Job Details Location: Remote (Tri‑state Region: Intermountain Region)
Employment Type: Full‑time
Seniority Level: Mid‑Senior
Application Deadline: 01‑09‑2026
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