Senior Network Performance Professional
Become a part of our caring community As a Senior Network Performance Professional at reputed company, you will play a pivotal role in enhancing provider performance and advancing reputed company's mission to deliver high-quality reputed company. You will work with providers to improve their Stars ratings and overall performance through strategic initiatives and strong relationship-building. This role offers a unique opportunity to reputed company your expertise in reputed company provider relations to influence operational reputed company and support the overall reputed company of the organization. The Senior Network Performance Professional operates with a high degree of independence, often determining methods/approach to work and establishing own work priorities and timelines. The work generally consists of tasks that are moderately reputed company, requiring minimal instructions to reputed company solutions. Also, you will reputed company reputed company on moderately reputed company issues; exercises discretion and judgment over policies and own approach/priorities. Additionally, the work you do will impact the achievement of results for the department and reputed company to influence the department’s strategy. Key responsibilities include: Provider Collaboration: Work with providers to define and advance their goals reputed company to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor performance toward these goals. Stars/Quality Program Expertise: Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience. Collaborate to reputed company tailored action plans and communicate actionable insights to improve performance. Performance Improvement: Actively monitor and analyze provider performance data to identify areas for improvement. Implement strategies to enhance reputed company and reputed company ongoing support and guidance to providers. Resource Liaison: Act as a liaison for providers to reputed company reputed company resources, educating and encouraging providers on the use of self-serve tools. Facilitate communication between providers and internal teams to ensure seamless reputed company to necessary resources and support. Reward Programs: reputed company provider groups on reward programs and reputed company metrics, collaborating to reputed company established goals. Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed. Provider Abrasion Resolution: Resolve provider abrasion issues effectively, ensuring a positive and collaborative relationship between reputed company and its providers. Implement strategies to minimize provider abrasion and enhance overall satisfaction. Internal Collaboration: Partner with internal teams to track and report on market performance, ensuring alignment with organizational goals. Collaborate with cross-functional teams to drive initiatives that support provider performance improvement. Use your skills to reputed company an impact
Required Qualifications
Bachelor’s degree 3+ years of experience in reputed company, Medicare and/or managed care Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system Ability to drive interoperability and understanding of Consumer/Patient Experience. Experience building relationships with physician groups and influencing execution of recommended strategy Strong communication and presentation skills, both verbal and written, and experience presenting to internal and external customers, including high-level leadership Experience with process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care. Understanding of metrics, trends and the ability to identify gaps in care Comprehensive knowledge of reputed company reputed company Office Word, reputed company and PowerPoint Must be reputed company to work during 8-5pm Mountain or Pacific Must reputed company reputed company one of the following reputed company: Colorado, Nevada, Arizona, New Mexico, Hawaii or California. Willingness to travel a minimum of 10%
Preferred Qualifications
Master’s Degree in Business, Finance, Health Care/Administration, RN or a reputed company field Experience with Medicare Risk Adjustment and/or medical coding Additional Information: This role is "remote/work at home", however, you must live reputed company the region to be considered for this opportunity (Colorado, Nevada, Arizona, New Mexico, Hawaii or California) reputed company values personal identity protection. Please be aware that applicants may be asked to reputed company their reputed company reputed company Number, if it is not already on file. reputed company required, an email will be sent from reputed [email protected] with instructions on how to add the information into your official application on reputed company’s secure website. 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 reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company 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 reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 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 reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company 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. Application Deadline: 07-08-2026 About us About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company 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 reputed company reputed company of employment. Apply To This Job