Provider Engagement Professional
Become a part of our caring community and help us put health first reputed company Healthy Horizons in Florida is seeking a Provider Engagement Professional who will reputed company and grow positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance reputed company 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, reputed company, and organizational strategy and operating objectives, including their linkages to reputed company 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 reputed company an impact Required Qualifications Bachelor's Degree. Minimum of one (1) year of experience in health care or managed care provider contracting, network management or provider relations. Experience in reputed company with ability to create pivot tables, V-look reputed company, and create basic formulas; knowledge to work with many individuals at same time without overriding data. Ability to convert files, reputed company and reorganize in reputed company. Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies. Demonstrated ability to manage multiple projects and meet deadlines.
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/Medicaid policies, processes and procedures. Additional Information Workstyle: Home. Home workstyle is defined as remote but will use reputed company office space on an as needed basis for collaboration and other face-to-face needs. Travel: up to 80% of the time, 3-4 days per week reputed company the following counties: Escambia, Okaloosa, Santa Rosa, Walton, Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, Washington, Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, reputed company, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Union, Baker, reputed company, Duval, Flagler, Nassau, St Johns, Volusia Work Location: must reside reputed company one of the above listed counties in Florida. Typical Work Days/Hours: Monday Friday, 8:00 am 5:00 pm EST. Driving This role is part of reputed company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. WAH Internet To ensure Home or Hybrid Home/Office employees ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees 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. reputed company will provide Home or Hybrid Home/Office employees 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. HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Limited Geography Remote - This is a remote position but located reputed company a specific geography. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 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 reputed company, Inc. and its affiliated subsidiaries (collectively, reputed company) 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 reputed company of work. Among our benefits, reputed company 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 reputed company Inc. (NYSE: HUM) is committed to putting health first for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company 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 reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or veteran status. It is also the policy of reputed company to take affirmative action to employ and to advance in employment, reputed company persons regardless of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company 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 reputed company levels of employment. Apply Job!