Manager, Network Performance

This is a fully remote position, open to applicants in Alabama, +3 more states.

📋 Description

• Lead and guide a team of associates who interact with providers.

• Act as the subject matter expert on CMS Stars, HEDIS, CAHPS, and HOS.

• Manage external communications with provider partners to enhance performance, optimize workflows, and monitor outcomes.

• Collaborate with teams across Provider Engagement, Stars, MRA, Interoperability, Clinical, Provider Contracting, Leadership, and other business partners.

• Ensure team priorities and execution align with organizational, regional, and departmental KPIs and OKRs.

• Facilitate cross-functional meetings and strategic initiatives.

• Analyze data, pinpoint insights and opportunities, and relay findings to leadership and the team.

• Create data-driven educational resources to bolster team performance.

• Oversee the daily operations and strategic execution for direct reports.

• Monitor and report on team and initiative performance outcomes.

• Cultivate a culture of engagement, well-being, and professional growth.

⛳️ Requirements

• 3-5 years of progressive experience in payer, healthcare, provider relations, quality improvement, or a related field.

• Proven track record of driving performance in complex healthcare settings.

• Previous experience with Medicare.

• Strong comprehension of value-based care models, provider performance enhancement, and quality-focused healthcare delivery.

• Familiarity with HEDIS/Stars, Interoperability, and Medicare Risk Adjustment.

• Proficient in analyzing and interpreting healthcare data, identifying trends and opportunities, and converting insights into actionable strategies.

• Experience in leading, coaching, mentoring, or developing team members.

• Availability to work during the hours of 8 AM to 5 PM EST/CST.

• Must reside in Alabama, Louisiana, Mississippi, or Tennessee.

• Bachelor’s degree in business, finance, healthcare, or a related field, or equivalent experience (preferred).

• Management experience, including leading and developing others (preferred).

• Progressive experience in the health solutions industry (preferred).

• Previous managed care or Medicaid experience (preferred).

• Minimum home internet speed of 25 Mbps download and 10 Mbps upload.

• A dedicated workspace free from ongoing interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Personal wellness and smart healthcare decision support.

• Remote/work-from-home arrangement.

• Occasional travel to Humana offices for training or meetings.