Company name
Humana Inc.
Location
Springfield, MO, United States
Employment Type
Full-Time
Industry
Healthcare, Nursing
Posted on
Feb 03, 2022
Profile
Job Information
Humana
Senior Provider Engagement, Clinical Professional - Remote, MO
in
Springfield
Missouri
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, andwork is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.
Required Qualifications
Must have an active LPN or RN license in MO with no restrictions
5-6 years of varied clinical nursing experience
Background analyzing data and working with reports
Strong team player and the ability to network effectively with other business groups
Strong communication skills both verbal and written
Strong presentation skills in virtual and in person environment
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Ability to work independently under general instructions
Proficient with Microsoft Office products including Word, Excel and Outlook
This position requires you to have a valid driver's license and personal vehicle liability insurance with at least 100,000/300,000/100,000 limits
Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required
Ability to provide a designated workspace; free from distractions with the ability to secure any protected information
Must live within a commutable distance from St. Louis, MO area to visit provider groups on a weekly basis
Preferred Qualifications
Bachelor's degree in Nursing, Business or Finance
Prefer Clinical experience to be Critical Care, ER, LTACH or HH
Plus to have Six Sigma
Background working with HEDIS and Stars measures
Experience working in a primary care physician (PCP) office
Previous insurance experience
Previous UM or CM in acute facility or insurance environment
Experience with multiple EMRs, Platforms such as Tableau or PowerBI
Additional Information
30% travel will be required locally within the state
This role is part of Humana's Driver Safety and Vehicle Management Program. Since this role will require driving for the Company, at least part of the time, you may be subject to continuous Motor Vehicle Record (MVR) monitoring and required to complete Humana's initial online driver's training.
This position is also eligible for mileage reimbursement for personal vehicles and to be covered
after
the first stop of the day and
before
the last stop of the day. Initial mileage to and from your home is not covered with exceptions for business travel incurred over and above the standard commute. Please ask your recruiter for additional details.
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
Provide proof of full vaccination, including booster or commit to testing protocols
*OR *
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state, and remote-only work exemptions are available.
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com