Senior Network Performance Professional

Become a Part of Our Caring Community and Help Us Put Health First

As a Senior Network Performance Professional at Humana, you will play a pivotal role in enhancing provider performance within the SouthEast Region and advancing Humana's mission to deliver high-quality healthcare. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building.

Key Responsibilities

• Works with SouthEast Region providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies
• Recommends execution strategies and monitor performance toward these goals
• Actively monitors and analyzes provider performance data to identify areas for improvement
• Serves as an expert on the Stars / Quality program, educating physician groups on HEDIS, patient safety, and patient experience
• Collaborates to develop tailored action plans and communicate actionable insights to improve performance
• Implements strategies to enhance outcomes and provide ongoing support and guidance to providers
• Acts as a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools
• Facilitates communication between providers and internal teams to ensure seamless access to necessary resources and support
• Educates provider groups on reward programs and target metrics, collaborating to achieve established goals
• Monitors and reports on the effectiveness of reward programs, making recommendations for enhancements as needed
• Resolves provider abrasion issues effectively, ensuring a positive and collaborative relationship between Humana and its providers
• Implements strategies to minimize provider abrasion and enhance overall satisfaction
• Partners with internal teams to track and report on market performance, ensuring alignment with organizational goals
• Collaborates with cross-functional teams to drive initiatives that support provider performance improvement

Use Your Skills to Make an Impact

Required Qualifications

Preferred Qualifications

Additional Information

This role is "remote / work at home", however, you must live within the region (North Carolina or South Carolina)

Work at Home Information

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range $78,400 - $107,800 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

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") 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 outside of work. Among our benefits, Humana 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

Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better 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 Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.