Senior Network Performance Professional

Become a part of our caring communityAs a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing provider performance within the Southeast Region and advancing Humana's mission to deliver high-quality healthcare. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building. You will report to the Manager, Network Performance.Key ResponsibilitiesWorks with Southeast Region providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategiesRecommends execution strategies and monitor performance toward these goalsActively monitors and analyzes provider performance data to identify areas for improvementServes as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experienceCollaborates to develop tailored action plans and communicate actionable insights to improve performanceImplements strategies to enhance outcomes and provide ongoing support and guidance to providersActs as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve toolsFacilitates communication between providers and internal teams to ensure seamless access to necessary resources and supportEducates provider groups on reward programs and target metrics, collaborating to achieve established goalsMonitors and reports on the effectiveness of reward programs, making recommendations for enhancements as neededResolves provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providersImplements strategies to minimize provider abrasion and enhance overall satisfactionPartners with internal teams to track and report on market performance, ensuring alignment with organizational goalsCollaborates with cross-functional teams to drive initiatives that support provider performance improvementBenefitsHumana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunitiesRequired QualificationsUse your skills to make an impact 4+ years' experience with Medicare and/or managed careUnderstanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey systemExperience building relationships with physician groups and influencing execution of recommended strategyComprehensive knowledge of all Microsoft Office Word, Excel and PowerPointExperience presenting to internal and external customers, including high-level leadershipMust be able to work during 8-5pm [Eastern]Willingness to travel a minimum of 10%Must be located within the Southeast regionPreferred QualificationsBachelor's Degree or Master's degree in business, Finance, Health Care/Administration, RN or a related fieldExperience with Medicare Risk AdjustmentProgressive experience with interoperability solutions in HealthcareProven organizational and prioritization skills and ability to collaborate with multiple departmentsAdditional InformationThis role is "remote/work at home", however, you must live within the Southeast regionWork-At-Home RequirementsTo ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationOur Hiring ProcessAs part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours40Pay RangeThe 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 pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$78,400 - $107,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description Of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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.About UsAbout Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.Equal Opportunity EmployerIt 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.