Senior Provider Engagement, Clinical Professional
Humana

Memphis, Tennessee

Posted in Insurance
about 1 month ago


This job has expired.

Job Info


Description

The Senior Provider Engagement, Clinical 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 Senior Provider Engagement, Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Provider Engagement, Clinical 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. This work focuses on areas of clinical emphasis. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications

  • BSN or Associate Degree in Nursing
  • Nursing license unrestricted in the state of Tennessee
  • 5+ years of experience working as a registered nurse
  • Excellent Communication skills
  • Excellent Organizational Skills
  • Well versed in Microsoft office, Excel and PowerPoint
  • Valid driver's license with reliable transportation and the ability to travel within the region up to 75% of the time
Preferred Qualifications
  • Managed care experience in Medicare and Medicaid
  • HEDIS knowledge
  • Experience with Medicare Stars
Additional Information

This position is "work at home/remote", however, you must live within the State of Tennessee and the ideal candidate will live in Shelby County.

Scheduled Weekly Hours

40


This job has expired.

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