网络性能经理
Manager, Network Performance
成为我们关怀社区的一员
网络性能经理领导一个致力于与供应商合作,提高关键质量和运营指标(包括医疗保障星级)的专业团队。通过与指定的医生团体进行战略协作和建立牢固的关系,这位领导者推动能提升供应商绩效、加强网络有效性并改善整体计划质量和会员结果的举措。主要职责
- 带领和发展面向供应商的团队成员
- 作为CMS星级、HEDIS、CAHPS、HOS方面的专家
- 监督团队与供应商合作伙伴的外部讨论,以推动绩效改进、流程优化和结果监控
- 与供应商参与、星级、MRA、互操作性、临床、供应商合同、领导和其他业务伙伴协作
- 将团队优先事项和执行与企业、地区和部门的KPI和OKR对齐
- 领导跨职能会议和战略举措
- 分析数据,识别洞察和机会,并向领导和团队传达发现
- 开发数据驱动的教育和资源以支持团队绩效
- 监督直接下属的日常运营和战略执行
- 监控并报告团队和项目的表现结果
- 培养积极的参与文化、福祉和职业发展
运用你的技能产生影响
所需资格条件
- 在支付方、医疗保健、供应商关系、质量改进或相关领域有3-5年逐步晋升的经验,并在复杂医疗环境中取得显著绩效提升成果
- 具有医疗保险经验,对基于价值的护理模式、供应商绩效改进和以质量为导向的医疗交付有深入理解,包括但不限于HEDIS/星级、互操作性和医疗保险风险调整
- 具备分析和解读医疗数据的能力,能够识别趋势和机会,并将洞察转化为可执行的战略,从而实现可衡量的改进
- 有带领、指导、辅导或培养团队成员的经验,包括培训和专业知识
- 能够在EST/CST时间8-5点工作
- 必须居住在[阿拉巴马州、路易斯安那州、密西西比州或田纳西州]区域内
优选资格条件
- 商业、金融、医疗保健或相关领域的学士学位
查看英文原文
Become a part of our caring community
The Manager of Network Performance leads a team of professionals dedicated to partnering with providers to improve performance on key quality and operational measures, including Medicare Stars. Through strategic collaboration and strong relationships with assigned physician groups, this leader drives initiatives that enhance provider performance, strengthen network effectiveness, and improve overall plan quality and member outcomes.Key Responsibilities
- Lead and develop a team of provider-facing associates.
- Serve as subject matter expert on CMS Stars, HEDIS, CAHPS, HOS.
- Oversee team’s external discussions with provider partners to drive performance improvement, workflow optimization, and outcome monitoring.
- Collaborate across Provider Engagement, Stars, MRA, Interoperability, Clinical, Provider Contracting, Leadership, and other business partners.
- Align team priorities and execution with enterprise, regional, and departmental KPIs and OKRs.
- Lead cross-functional meetings and strategic initiatives.
- Analyze data, identify insights and opportunities, and communicate findings to leadership and the team.
- Develop data-driven education and resources to support team performance.
- Oversee daily operations and strategic execution for direct reports.
- Monitor and report team and initiative performance results.
- Foster a strong culture of engagement, well-being, and professional development.
Use your skills to make an impact
Required Qualifications
- 3-5 years progressive experience in the payer, healthcare, provider relations, quality improvement or related space with demonstrated success in driving performance in complex healthcare environments
- Prior Medicare experience with a strong understanding of value-based care models, provider performance improvement, and quality-focused healthcare delivery including but not limited to HEDIS/Stars, Interoperability, and Medicare Risk Adjustment
- Proven ability to analyze and interpret healthcare data, identify trends and opportunities, and translate insights into actionable strategies that drive measurable improvement.
- Experience leading, coaching, mentoring, or developing associates, including training and subject matter expertise
- Must be able to work during 8-5pm EST/CST
- Must live within the region [Alabama, Louisiana, Mississippi, or Tennessee]
Preferred Qualifications
- Bachelor’s degree in business, finance, healthcare, or related field, or equivalent experience
- Management experience, leading and developing others
- Progressive experience in the health solutions industry
- Prior managed care or Medicaid experience
Additional Information
This role is "remote/work at home", however, you must live within the region (Alabama, Louisiana, Mississippi, or Tennessee) to be considered for this opportunity.
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 suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. 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
40Pay 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 yearThis 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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.
Originally posted on Himalayas