The Market Management Consultant (PODS Owner) will:|
Lead the PODS team to positively impact medical costs, improve documentation/coding accuracy and improve outcomes
Accountable for provider prioritization and communication of priorities to the PODS team
Facilitate regular Provider Engagement Strategy meetings
Clarify scope of work commitments and deliverables, and define measurable success criteria to monitor progress towards goals
Accountable for development and use of provider specific care plans, and prioritize, track and trend document action plans and goals
Maintain provider relationships; deliver provider specific metrics and effectively address provider needs and PODS team goals
Define gaps in Humana's service relationship with providers and facilitate resolution
Provide resources and educational opportunities to providers and staff
Facilitate members' participation in clinical programs & identify opportunities to improve member participation
Builds Trust: You honor your word by doing what you say you are going to do.
Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools.
Innovates: Introduces or develops new ideas and processes which improve performance and productivity. Generates insights through thought leadership. Leverages business intelligence, data, insights, and other research to drive differential value and expand Humana's capability to compete.
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.
Prior experience in a fast paced insurance or health care setting
Experience with provider relations/network and demonstrated relationship building skills
Computer literate (MS Word, Power Point, Excel)
Proven analytical skills
Project leadership experience
Excellent verbal & written communication skills
Ability to travel locally and overnight up to 50% of the time
Minimum High School diploma to be employed at Humana
Bachelor’s Degree strongly preferred
Managed care experience
Work Environment Type
Yes, 50 % of the Time
Humana Inc. (Humana) is a full-service benefits solutions company, offering an array of health and supplemental benefit plans for employer...