Provider Engagement Consultant - Hattiesburg

Company: Humana ( Learn More )

General Information
Not Specified
Not Specified
Up to 25%
Job Description Role:  Provider Engagement Consultant
Assignment: Medicare/HEDIS
Location: South Mississipi - Hattiesburg, Biloxi, Gulfport area  

Humana is seeking a Provider Engagement Consultant who will develop and maintain key relationships; works with assigned area to optimize business results.  Manage provider groups to achieve quaford area

lity and P&L goals. Create strategic provider partnerships to improve health efficiencies, and foster provider experience while ensuring cohesion across product lines. Create strategic provider partnerships to value providers to improve their experience with Humana.  Be a strong partner and build relationships with internal stakeholders to create a seamless experience for the provider.

  • Execute profitable growth strategies
  • Develop and/or implement processes and data sharing structure for assigned providers 
  • Strong facilitation skills with an ability to run provider meetings (JOC or PCP meeting) with prioritized specific topic agenda reflecting entire provider support organization
  • Develop and review Dashboard Metrics (quality, financial, triple AIM)  and translate into actionable items based on group specifics.
  • Ability to train others to use the tools that will make the PCP successful
  • Facilitate clinical education, leveraging clinical experience from your internal partners
  • Ability to provide actionable financial and operational data, and ensure action plans are implemented to achieve performance goals
  • Be the defined point of contact for the provider and communication according to group agreements. 
  • Influence provider culture and strategy to elevate capability of the provider community to support the ever changing healthcare environment. 
  • Work to improve EMR capability
  • Partner with the provider and the company to develop capability for sustained, integrated consumer interaction programs building consumer and customer advocacy and loyalty.

  • Job RequirementsRole Essentials
      • Prior experience in a fast paced insurance or health care setting
      • Computer literate (MS Word, Power Point, Excel). Proven analytical skills, spreadsheet modeling and database development.
      • Excellent communication skills, both oral and written
      • Strong oral and written communication skills.
      • Knowlede of HEDIS required
      • Strong relationship building skills
      • This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits.

    Role Desirables
      • Bachelor's degree or RN preferred
      • Knowledge of Humana’s internal policies, procedures and systems.

    Reporting Relationships

    You will report to Market Manager.  This area is under the leadership of the SVP & Chief Operating Officer. 


    Additional Information
    As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
    If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.