Senior Network Performance Professional at Humana in Georgia

Senior Network Performance Professional Location: Remote Virginia Become a part of our caring community As 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. As 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 Responsibilities: Work with Southeast Region providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies Recommend execution strategies and monitor performance toward these goals Actively monitor and analyze provider performance data to identify areas for improvement Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience Collaborate to develop tailored action plans and communicate actionable insights to improve performance Implement strategies to enhance outcomes and provide ongoing support and guidance to providers Acts as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools Facilitate communication between providers and internal teams to ensure seamless access to necessary resources and support Educate provider groups on reward programs and target metrics, collaborating to achieve established goals Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed Resolve provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providers Implement strategies to minimize provider abrasion and enhance overall satisfaction Partner with internal teams to track and report on market performance, ensuring alignment with organizational goals Collaborate with cross-functional teams to drive initiatives that support provider performance improvement Use your skills to make an impact Required Qualifications Must be located and reside within the Southeast region Minimum 4 years of experience with Medicare and/or managed care Knowledge/Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system Experience building relationships with physician groups and influencing execution of recommended strategy Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint Experience presenting to internal and external customers, including high-level leadership Willingness to travel a minimum of 10% Work-At-Home Requirements At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates 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 information Preferred Qualifications Advanced degree in business, Finance, Health Care/Administration, RN or a related field Experience with Medicare Risk Adjustment Progressive experience with interoperability solutions in healthcare Proven organizational and prioritization skills and ability to collaborate with multiple departments Additional Information As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews. 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 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 year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, 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 us About 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 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. Additional Locations: Remote Georgia, Remote North Carolina, Remote South Carolina