The Director, Provider Engagement 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 Director, Provider Engagement requires an in-depth understanding of how organization capabilities interrelate across the function or segment.
The Director, Provider Engagement will lead and manage the development of Humana’s overall provider relationships within a geographic region. Drive strategic initiatives within the provider network and ensure that the alignment of departmental objectives is congruent with the overall business strategy. Provide leadership that combines broad vision with a critical eye for internal operations and quality assurance. The Director, Provider Engagement contributes to the success of Humana’s strategy by formulating and executing the organizations strategy, driving for exceptional results, motivating managers and associates.
Lead annual strategy planning and drive follow up by aligning market goals with corporate and regional strategy
Identify the providers who will move along a path to value and execute a strategy to achieve that goal. Create a compelling argument to entice all other providers to explore emerging value-based arrangements
Monitor and share company, market and provider-specific metric reports for improvement opportunities
When the market need arises…Cultivate strategic opportunities to delegate portions of a health plan (UM, case management, SNP for example) to provider groups and oversee implementation of structure to support delegation.
Manage the team to engage the business offices in annual strategy planning and follow up, and align market goals with corporate and regional strategy and drive these goals into the practice leveraging clinical resources
Provide sounding board/forum for the provider’s practice concerns
Develop and execute shared strategy with MarketPoint Sales Organization to grow market share with engaged providers
Develop and manage execution of market outreach activities directed to current and future members
Provide leadership and direction for all functions related to Health Plans for a specific market area.
Optimize Business performance by coordinating with the network, sales, compliance for all business purposes, and will provide leadership and direction for all functions
Develop strategies which will increase sales for retention and for growth
Understand Humana’s marketplace, industry and Medicare regulatory environment assuring all functions are running properly
Management of staff including performance, compliance, recruiting
Build a cohesive team by establishing clear direction, goals and responsibility.
Bachelor’s degree or 7 plus years prior provider development/engagement experience
5 plus years management/leadership experience
Prior experience in strategic execution, business and financial acumen, and clinical experience
Proven ability to build strong long lasting relationships with both internal partners and external providers
Prior demonstrated leadership working in a Market Operations environment
5 plus years provider engagement experience and working in a global risk environment
Excellent communication skills, both oral and written
Experience thriving in a matrix environment
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.
Graduate degree strongly preferred
Knowledge of Humana’s internal policies, procedures and systems
You will report to a Regional Vice President and will have 4-5 direct reports
Scheduled Weekly Hours
Equal Opportunity Employer
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