Program Delivery Lead

Become a part of our caring community and help us put health first
 

The Program Delivery Lead will support programs designed to maximize value-based relationships with Providers in our Gulf South Region. We are looking for a dynamic healthcare professional who can drive network performance with a focus on interoperability, MRA coding and closing gaps in care. This is a unique opportunity to work with corporate teams and professionals in the field and use your understanding of electronic health data solutions to impact the business and our members.

The Program Delivery Lead drives the quantity and quality of EMR data connections and supplemental data files. They partner with leaders regarding implementation planning, communicating the results of programs and advising executives to develop functional strategies on matters of significance. They ultimately help providers’ systems perform better by working on challenges with different EMR programs. Responsibilities will fall into the following areas:

Corporate interconnectedness (30%)

• Identify new interoperability targets for Epic, eCW and Athena by using a variety of available lists and sources.

• Collaborate with Interoperability Recruiting and Implementation team on regional provider Implementations in Process.

• Develop and maintain regional Live Connection Tracking report

• Manage Implementations in Process reporting to track progress and follow up with Interoperability teams.

• Follow progress, submit, and track the Interoperability Support Request Intake process.

Strategy & Operations (30%)

• Consider potential regional and provider goals and targets for next implementations.

• Collaborate to establish priorities based on next product for implementation.

• Manage and develop a regional process to track providers in progress: push to contracting and follow up to communicate progress until fully executed.

• Identify and research groups with low performance measures related to prospective programs.

Market support (40%)

• Engage and assist market with understanding of providers’ Interoperability products.

• Coordinate scheduling and communication for providers’ kick-off meetings and provide resources to the team and providers.

• Oversee and track regional health data new connections, while maintaining and communicating regional data outage report.

• Report both HEDIS and Lab data feeds where providers have a missing data submission.

• Manage Data Retrieval Method maximization, including Cotiviti retrieval methods and identify sites with active interoperability pathways to ensure appropriate retrieval method is implemented.

Success in this position requires the following key attributes:

• Ability to self-direct, take initiative and meet deadlines

• Use of independent judgment to analyze variable factors and determine the best course of action.

• Strong time-management and prioritization skills, with stellar attention to detail

• Excellent organizational skills, with ability to manage multiple priorities, maintain clear structure in complex workflows and ensure timely, accurate completion of responsibilities in fast-paced environment

• Impeccable attention to detail, identifying discrepancies, improving data integrity, and elevating operational accuracy across high impact initiatives

• Strong analytical thinking and problem-solving skills

• Proven relationship building skills with ability to act as a liaison between corporate and market professional and providers in the field

Use your skills to make an impact
 

Required Qualifications

• 5 or more years of experience in Managed Care with Stars, Risk Adjustment or Network Management experience

• 2 or more years of experience in project work or process improvement

• Advanced working knowledge of MS Excel (vLookups, pivot tables)

• Experience partnering with leadership on strategic initiatives

• Demonstrated ability to articulate ideas effectively in both written and oral forms

Preferred Qualifications

• Bachelor's degree or higher in a related field

• PMP certification a plus

• Experience working with health data collected from Electronic Health Records (EHR), Health Information Systems (HIS), or other healthcare IT systems.

• Six Sigma Certification also a plus

• Live within the stated region

Additional Information

This role is "remote/work at home" and can be based anywhere in the United States, however, preference will be given to candidates that live/work within the region (AL, MS, TN, LA, SW VA)

Work-At-Home Requirements

To ensure Home-based 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.

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.

 

$115,200 - $158,400 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.

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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.