Senior Provider Engagement Professional
Centerwellprimarycare, Phoenix, Arizona, United States
Role Overview
The Senior Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted relationship with the health plan. The work assignments involve moderately to complex issues where analysis of situations or data requires an in-depth evaluation of variable factors.
The role encompasses the scope of the health plan/provider relationship across areas such as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, and other factors related to provider performance, member experience, market growth, provider experience, and operational excellence. The Professional will influence departmental strategy, make decisions on complex technical approaches for project components, and work autonomously with considerable latitude in determining objectives and approaches.
Work Arrangement NOTE: This is a work-from-home position requiring some travel to provider offices in and around the Peoria to Phoenix areas, but the majority of the work is performed from home.
Job Functions
Travel consisting of monthly provider visits, with occasional quarterly travel to Las Vegas for team meetings.
Distribute the Census Management Report (Admits / Discharges) to each practice.
Monitor issues and action items in MSO Connect (membership, payment, contract load).
Email inbox management.
Follow‑up on existing action items and outreach management.
Research and respond to MSO Member grievances from providers.
Facilitate resolution of provider escalations or concerns, coordinating with internal departments as needed.
Evaluate DataHub for quality management, cost and utilization, develop interventions, and evaluate provider workflows.
Attend team meetings, external meetings, and shared service partner collaboration meetings.
Required Qualifications
Bachelor's Degree.
Five or more years of experience in healthcare or managed care in provider contracting, network management, or provider relations.
Some travel to provider offices in and around the Peoria to Phoenix areas is required; the role is largely remote.
Ability to work independently and under minimal supervision.
Prior healthcare consulting experience is required; a strong, knowledgeable provider engagement professional preferably in the managed care space (Medicaid/Medicare).
Proven planning, preparation, and presentation skills, with established knowledge of reimbursement and bonus methodologies.
Demonstrated ability to manage multiple projects and meet deadlines.
Preferred Qualifications
Master's Degree.
Candidate who works/live in Arizona is preferred.
Proficiency in analyzing and interpreting financial trends for healthcare costs, administrative expenses, and quality/bonus performance.
Comprehensive knowledge of Medicare policies, processes, and procedures.
Use Your Skills To Make An Impact Humana values personal identity protection. Applicants may be asked to provide their Social Security Number if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information to the official application on Humana’s secure website.
Interview Format – HireVue As part of our hiring process for this opportunity, we will be using HireVue, an interviewing technology that enables us to quickly connect and gain valuable information about your relevant skills and experience at a time that fits your schedule.
Benefits
Health benefits effective day 1.
Paid time off, holidays, volunteer time, and jury duty pay.
Recognition pay.
401(k) retirement savings plan with employer match.
Tuition assistance.
Scholarships for eligible dependents.
Parental and caregiver leave.
Employee charity matching program.
Network Resource Groups (NRGs).
Career development opportunities.
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 range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job‑related skills, knowledge, experience, education, and certifications.
$71,100 - $97,800 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.
Description Of Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being. Associate benefits encourage personal wellness and smart healthcare decisions for you and your family while recognizing that life extends beyond work. Benefits include medical, dental, and vision coverage; 401(k) retirement savings plan; time off (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 CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, and minor injury treatment. Our unique care model focuses on personalized experiences, listening, learning, and addressing factors that impact patient well‑being. Our integrated care teams—including physicians, nurses, behavioral health specialists, and more—spend up to 50 percent more time with patients, delivering compassionate, personalized care that yields better health outcomes. We address physical health and other factors that can impact a patient’s well‑being.
CenterWell is a Humana company that creates experiences that put patients at the center. As the nation’s largest provider of senior‑focused primary care, one of the largest providers of home health services, and the fourth largest pharmacy benefit manager, CenterWell focuses on whole‑person health by addressing the physical, emotional, and social wellness of patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry‑leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians committed to putting health first—for teammates, patients, communities, and the company—from day one.
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 follows Section 503 of the Rehabilitation Act and VEVRAA, employing and advancing individuals with disability or protected veteran status while basing all employment decisions on valid job requirements. This policy applies to all employment actions, including recruitment, hiring, promotions, transfers, layoffs, recalls, terminations, pay, and training selection at all levels.
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The role encompasses the scope of the health plan/provider relationship across areas such as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements, and other factors related to provider performance, member experience, market growth, provider experience, and operational excellence. The Professional will influence departmental strategy, make decisions on complex technical approaches for project components, and work autonomously with considerable latitude in determining objectives and approaches.
Work Arrangement NOTE: This is a work-from-home position requiring some travel to provider offices in and around the Peoria to Phoenix areas, but the majority of the work is performed from home.
Job Functions
Travel consisting of monthly provider visits, with occasional quarterly travel to Las Vegas for team meetings.
Distribute the Census Management Report (Admits / Discharges) to each practice.
Monitor issues and action items in MSO Connect (membership, payment, contract load).
Email inbox management.
Follow‑up on existing action items and outreach management.
Research and respond to MSO Member grievances from providers.
Facilitate resolution of provider escalations or concerns, coordinating with internal departments as needed.
Evaluate DataHub for quality management, cost and utilization, develop interventions, and evaluate provider workflows.
Attend team meetings, external meetings, and shared service partner collaboration meetings.
Required Qualifications
Bachelor's Degree.
Five or more years of experience in healthcare or managed care in provider contracting, network management, or provider relations.
Some travel to provider offices in and around the Peoria to Phoenix areas is required; the role is largely remote.
Ability to work independently and under minimal supervision.
Prior healthcare consulting experience is required; a strong, knowledgeable provider engagement professional preferably in the managed care space (Medicaid/Medicare).
Proven planning, preparation, and presentation skills, with established knowledge of reimbursement and bonus methodologies.
Demonstrated ability to manage multiple projects and meet deadlines.
Preferred Qualifications
Master's Degree.
Candidate who works/live in Arizona is preferred.
Proficiency in analyzing and interpreting financial trends for healthcare costs, administrative expenses, and quality/bonus performance.
Comprehensive knowledge of Medicare policies, processes, and procedures.
Use Your Skills To Make An Impact Humana values personal identity protection. Applicants may be asked to provide their Social Security Number if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information to the official application on Humana’s secure website.
Interview Format – HireVue As part of our hiring process for this opportunity, we will be using HireVue, an interviewing technology that enables us to quickly connect and gain valuable information about your relevant skills and experience at a time that fits your schedule.
Benefits
Health benefits effective day 1.
Paid time off, holidays, volunteer time, and jury duty pay.
Recognition pay.
401(k) retirement savings plan with employer match.
Tuition assistance.
Scholarships for eligible dependents.
Parental and caregiver leave.
Employee charity matching program.
Network Resource Groups (NRGs).
Career development opportunities.
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 range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job‑related skills, knowledge, experience, education, and certifications.
$71,100 - $97,800 per year. This job is eligible for a bonus incentive plan based upon company and/or individual performance.
Description Of Benefits Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole‑person well‑being. Associate benefits encourage personal wellness and smart healthcare decisions for you and your family while recognizing that life extends beyond work. Benefits include medical, dental, and vision coverage; 401(k) retirement savings plan; time off (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 CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, and minor injury treatment. Our unique care model focuses on personalized experiences, listening, learning, and addressing factors that impact patient well‑being. Our integrated care teams—including physicians, nurses, behavioral health specialists, and more—spend up to 50 percent more time with patients, delivering compassionate, personalized care that yields better health outcomes. We address physical health and other factors that can impact a patient’s well‑being.
CenterWell is a Humana company that creates experiences that put patients at the center. As the nation’s largest provider of senior‑focused primary care, one of the largest providers of home health services, and the fourth largest pharmacy benefit manager, CenterWell focuses on whole‑person health by addressing the physical, emotional, and social wellness of patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry‑leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians committed to putting health first—for teammates, patients, communities, and the company—from day one.
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 follows Section 503 of the Rehabilitation Act and VEVRAA, employing and advancing individuals with disability or protected veteran status while basing all employment decisions on valid job requirements. This policy applies to all employment actions, including recruitment, hiring, promotions, transfers, layoffs, recalls, terminations, pay, and training selection at all levels.
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