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Senior Provider Engagement Professional - Practice Transformation
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- The Senior Provider Engagement Professional- Practice Transformation is responsible for driving provider performance programs, goals and improvement metrics for network providers and partnerships.
- The Engagement Professional is an integral part of a cross-functional, collaborative organization which includes Provider Service Experience, Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment.
- Reporting to the Associate Director and/or Market Development Advisor, the Sr. Provider Experience Professional- ensures the effective management of provider performance programs for Humana Healthy Horizons in Ohio.
- The Senior Provider Engagement Professional- Practice Transformation represents the scope of health plan/provider relationship across such areas 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 areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.
- Supporting HEDIS & Risk Adjustment initiatives and Ohio Department of Medicaid quality initiatives for PRAF, Diabetes and other targeted campaigns.
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