Sr. Program Delivery Professional - Veterans Staffing : Job Details

Become a part of our caring community and help us put health first. The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Provider Reconciliation Program (PRP) is committed to delivering comprehensive and accurate reconciliation of claims data to uphold the highest standards of data integrity and drive positive member outcomes. By partnering closely with providers, we proactively work to decrease claim outages and increase the volume of organic claim submissions, ensuring a seamless experience for both providers and members. The robust data we capture directly supports closure of HCC and Stars gaps, advancing quality, compliance, and organizational performance. The Senior Program Delivery Professional develops programs designed to drive value-based relationships. Partners with leaders regarding implementation planning. Reviews and communicates results of programs. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications:

• Bachelor's degree or equivalent experience
• Ability to interpret complex data sets and provide actionable insights
• Strong knowledge of Microsoft Office products
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Demonstrated experience building and maintaining provider relationships
• Proven skill in handling competing priorities while staying organized and focused
• Proven passion about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications:

• CPC (Certified Professional Coder) Certification
• Proficiency in data analysis tools and platforms
• Demonstrated expertise in working collaboratively on IT projects
• Demonstrated ability to communicate technical information clearly to non-technical stakeholders
• Demonstrated experience with anticipating future needs
• Experience facilitating educational meetings and developing provider-facing educational materials

Additional Information:

Benefits Information: Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial securityboth today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

Work At Home / Internet Information:

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 suggested.
• 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.

SSN Information: Humana values 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 [email protected] with instructions on how to add the information into your official application on Humana's secure website.

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. $86,300 - $118,700 per year.

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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.