Become a part of our caring community and help us put health first
The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.
Overview
The Michigan Provider Services Advisor is responsible for strategic and tactical support of the Provider Services team. Responsibilities will include strategic operations of the team, process development and improvement to drive standardization and efficiencies across the team, completing related state reports, and developing and executing upon a provider communication and provider materials development strategy. Initially, the Advisor will play a key role in supporting new market implementation activities. This position partners cross-functionally within the market and across the enterprise on matters of significance. This position exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.
Position Responsibilities
Advise Provider Services Associate Director on strategic and day-to-day operations of the overall Provider Services team, which includes provider relations and provider engagement.
Establish infrastructure to measure KPIs and other metrics to ensure compliance with related contractual requirements.
Develop initial and manage annual updates of the market's Provider Support Plan, in partnership with the Associate Director, as well as any other related required state reporting.
Oversee provider communications (fax blasts, emails, bulletins, website or provider portal content updates) end-to-end process, including development of content and management through the approval process.
Manage provider training and education strategy, including advising on and/or creating market-based provider materials and contributing to provider manual and required training materials.
Prior to market go-live, contribute to implementation of contractual requirements and day-to-day business processes/functions.
Lead process development or improvement and rollout to team members to drive efficiency, standardization, and best practices.
Drive development of ad-hoc strategic initiatives to execute on the Provider Journey, Provider Relationship Management model, and other strategic initiatives.
Facilitate workgroup calls/meetings/discussions to ensure successful execution of Provider Support Plan.
Partner with corporate Medicaid Provider Services team to rollout new segment-wide process or technology enhancements in support of the overall Provider Services team.
Use your skills to make an impact
Required Qualifications
Bachelor's degree or equivalent experience of 6 years
3+ years of related experience, including provider relations or engagement, provider communications and education, and/or related health plan operations.
2+ years of project management experience.
Strategic thinker with the ability to identify, prioritize, and solve complex business problems.
Strong attention to detail.
Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partners.
Preferred Qualifications
Master's degree.
Experience working in Medicaid.
Understanding of managed care contracts, including contract language and reimbursement.
Familiarly with DSNP/Medicaid-Medicare integration.
Strong understanding of health plan operations.
Experience operating in a matrixed environment.
Project management certification.
Additional Information
Work-At-Home Requirements
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 required; wireless, wired cable or DSL connection is required.
Satellite, cellular and microwave connection 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.
Humana 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.
Social Security Number Statement
Humana value's personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive an email and Text correspondence inviting you to participate in a SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn't missed)
In the SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this @type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
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
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$94,900 - $130,500 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. This policy shall apply to all 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 all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
