CenterWell Senior Primary Care
Provider Engagement Professional
CenterWell Senior Primary Care, Florida, New York, United States
Provider Engagement Professional
Join to apply for the Provider Engagement Professional role at CenterWell Senior Primary Care.
Become a part of our caring community and help us put health first.
Pay Range $59,300 – $80,900 per year (Base pay).
Responsibilities
Develop and grow positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance.
Interpret and independently determine appropriate courses of action as required by varied assignments.
Represent health plan/provider relationships across financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, and other areas related to provider performance, member experience, market growth, provider experience, and operational excellence.
Understand departmental, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Make decisions regarding own work methods with minimal direction; receive guidance when needed.
Follow established guidelines/procedures.
Target Gulf Coast counties: Lee, Collier, Charlotte, Sarasota, and/or Manatee.
Required Qualifications
Minimum of three years experience in healthcare or managed care with provider contracting, network management or provider relations experience.
Proven planning, preparation and presenting skills; knowledge of reimbursement and bonus methodologies.
Demonstrated ability to manage multiple projects and meet deadlines.
Passion for contributing to continuous consumer experience improvement.
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance.
Preferred Qualifications
Bachelor’s Degree.
Comprehensive knowledge of Medicare policies, processes and procedures.
Value-based care knowledge.
Additional Information
Remote role.
50% local travel between clinics; mileage reimbursement will be issued.
Driver safety program; valid state driver's license and required insurance coverage.
Work from Home: internet service meeting minimum criteria (25 Mbps download, 10 Mbps upload).
Employees in CA, IL, MT, SD may receive bi-weekly internet stipend.
Telecommunications equipment provided for home/office employees.
Dedicated workspace required to protect member PHI / HIPAA information.
Seniority Level Mid-Senior level
Employment Type Full-time
Job Function Other
Industries Hospitals and Health Care
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.
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Become a part of our caring community and help us put health first.
Pay Range $59,300 – $80,900 per year (Base pay).
Responsibilities
Develop and grow positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance.
Interpret and independently determine appropriate courses of action as required by varied assignments.
Represent health plan/provider relationships across financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, and other areas related to provider performance, member experience, market growth, provider experience, and operational excellence.
Understand departmental, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Make decisions regarding own work methods with minimal direction; receive guidance when needed.
Follow established guidelines/procedures.
Target Gulf Coast counties: Lee, Collier, Charlotte, Sarasota, and/or Manatee.
Required Qualifications
Minimum of three years experience in healthcare or managed care with provider contracting, network management or provider relations experience.
Proven planning, preparation and presenting skills; knowledge of reimbursement and bonus methodologies.
Demonstrated ability to manage multiple projects and meet deadlines.
Passion for contributing to continuous consumer experience improvement.
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses, and quality/bonus performance.
Preferred Qualifications
Bachelor’s Degree.
Comprehensive knowledge of Medicare policies, processes and procedures.
Value-based care knowledge.
Additional Information
Remote role.
50% local travel between clinics; mileage reimbursement will be issued.
Driver safety program; valid state driver's license and required insurance coverage.
Work from Home: internet service meeting minimum criteria (25 Mbps download, 10 Mbps upload).
Employees in CA, IL, MT, SD may receive bi-weekly internet stipend.
Telecommunications equipment provided for home/office employees.
Dedicated workspace required to protect member PHI / HIPAA information.
Seniority Level Mid-Senior level
Employment Type Full-time
Job Function Other
Industries Hospitals and Health Care
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.
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