Senior Network Performance Professional
$78,400–$107,800 year
Remote · Tennessee, United States or Alabama, United States
Job Summary
Senior Network Performance Professional focused on provider collaboration to advance interoperability, quality, value-based arrangements, and risk adjustment strategies. Serves as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience, and develops tailored action plans to improve performance. Monitors provider performance data to identify improvements, guides access to Humana resources, and educates on reward programs. Extensive collaboration with internal teams to track market performance and drive initiatives, with travel as needed and the role performed remotely from Alabama or Tennessee.
Required Qualifications
- 5+ years of healthcare experience
- 3+ years of experience with Medicare and/or managed care
- Understanding of NCQA HEDIS measures, Patient Safety Measures, CMS Star Rating System and CAHPS/HOS survey system
- Experience building relationships with physician groups and influencing execution of recommended strategy
- Experience with focus on process and quality improvement
- Must live in Alabama or Tennessee
- Willingness to travel a minimum of 10% within the region
- Strong communication and presentation skills
Desired Qualifications
- 5+ years of healthcare experience
- 3+ years of experience with Medicare and/or managed care
- Understanding of NCQA HEDIS measures, Patient Safety Measures, CMS Star Rating System and CAHPS/HOS survey system
- Experience building relationships with physician groups and influencing execution of recommended strategy
- Progressive experience with interoperability
- Strong communication and presentation skills, both verbal and written
- Willingness to travel up to 10% within the region
- Remote/work-from-home flexibility with location requirement in Alabama or Tennessee
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