Provider Engagement Professional- Conviva Daytona

Become a part of our caring community and help us put health first
The Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional work assignments are... varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Provider Engagement Professional 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. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
Use your skills to make an impact
Required Qualifications
?Bachelor's Degree
?1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
?Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
?Demonstrated ability to manage multiple projects and meet deadlines
?Must be passionate about contributing to an organization focused on continuously improving consumer experiences
?Must reside in or near Daytona, FL.
Preferred Qualifications
?Master's Degree
?Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
?Comprehensive knowledge of Medicare policies, processes and procedures
Additional Information
Working Hours: Monday ?Friday 8:00 to 5:00
Humana 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?oth today and in the future, including:
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
This role is considered patient facing and is part of Humana? Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Alert
Humana values personal identity protection. Please be aware that 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 on how to add the information into your official application on Humana? secure website.
Scheduled Weekly Hours
40
About us
About Conviva: Conviva Care Centers provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of Humana? Primary Care Organization, which includes CenterWell Senior Primary Care, Conviva? innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health ?addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.
About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first ?for our teammates, our customers, and our 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, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of ?umana 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 because he or she is a protected veteran. It is also the policy of ?umana?o take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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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