Senior Network Performance Consultant

ConsultantConsultantFull TimeRemoteTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

North Carolina + 2 moreAll locations: North Carolina, South Carolina, Virginia

Posted

29 days ago

Salary

$78.4K - $107.8K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Work with SouthEast Region providers to define and advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies • Recommend execution strategies and monitor performance toward these goals • Actively monitor and analyze provider performance data to identify areas for improvement • Be an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience • Collaborate to develop tailored action plans and communicate applicable insights to improve performance • Implement strategies to enhance outcomes and provide ongoing support and guidance to providers • Be a liaison for providers to access Humana resources, educating and encouraging providers on the use of self-serve tools • Educate provider groups on reward programs and target metrics, collaborating to achieve established goals • Monitor and reports on the effectiveness of reward programs, making recommendations for enhancements • Resolve provider abrasion issues, ensuring a positive and collaborative relationship between Humana and its providers • Collaborate with teams to drive initiatives that support provider performance improvement

Job Requirements

  • 5 or more years' experience with Medicare and/or managed care
  • Understanding of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system
  • Experience building relationships with physician groups and influencing execution of recommended strategy
  • Comprehensive knowledge of all Microsoft Office Word, Excel and PowerPoint
  • Experience presenting to internal and external customers, including high-level leadership

Benefits

  • 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

Related Categories

Related Job Pages

More Consultant Jobs

Health Coach Consultant, RN

CVS Health

Bringing our heart to every moment of your health.

Consultant29 days ago
Full TimeRemoteTeam 10,001+Since 1963H1B No Sponsor

Health Coach Consultant promoting member health decisions

Connecticut
$66.6K - $142.6K / year

Eligibility Consultant – Electronic

CVS Health

Bringing our heart to every moment of your health.

Consultant29 days ago
Full TimeRemoteTeam 10,001+Since 1963H1B No Sponsor

Design and audit ID cards for CVS Health clients.

New York + 2 moreAll locations: New York, Minnesota, Vermont
$17 - $34 / hour

Consultant II

NETSYNC

Netsync specializes in collaboration & unified communications, data center and cloud, network infrastructure and others. NETSYNC is an NMSDC-certified minority business enterprise (MBE), federally certified woman-owned small business (WOSB), and HUB-certified value-added reseller (VAR), specializing in the implementation of comprehensive IT life cycle solutions for a wide array of organizations. As a Cisco Gold, Master Collaboration, and Master Security Partner; an HP and Intel Platinum Partner; and holding certifications and specializations from many of the industry’s leading technology manufacturers, NETSYNC has extensive experience performing large-scale implementations and deploying complex IT solutions for K-12 and higher education institutions, civic organizations, municipalities, government agencies, and corporate clients across several industries, including energy, healthcare, retail, and financial services. Based in Houston, TX, with international offices, NETSYNC uses a blended approach that is both consultative and collaborative. We work with our clients to assess their needs, architect innovative technology solutions to meet those needs, and offer 24/7 access to our team of engineering experts who exceed clients’ expectations. This approach has earned NETSYNC numerous customer service excellence awards and recognition as a progressive partner that introduces the newest, best-of-breed products and solutions to clients.

Consultant29 days ago
Full TimeRemoteTeam 450Since 2002

The Consultant II will implement and support Collaboration solutions for enterprise clients, provide Tier 2 technical support, manage project documentation, and ensure solutions meet business needs. This role requires strong network and Collaboration knowledge.

Ccnp-CollaborationCollaboration ProductsData Center TechnologiesNetwork Protocols
Texas
Full TimeRemoteTeam 501-1,000Since 1974H1B No Sponsor

Senior Consultant leading Medicaid policy initiatives for BerryDunn

United States
$110K - $125K / year