Become a part of our caring community and help us put health first
 The Director, Provider Activation is responsible for the end-to-end process of adding providers to Humana’s network and maintaining payment terms so that claims are paid accurately and timely, for all provider types and all fee-for-service contracts. The role includes ownership of both internal and external functions that support provider activation, issue resolutions, and horizontal stakeholder / functional alignment (e.g. coordination with market NOCs who do not report directly to the provider activation team). This leader owns the day-to-day production of contract load, participates in the development of strategic plans to increase productivity, and oversees execution of relevant initiatives.

The Director, Provider Activation motivates, manages, and leads high-performance teams involved in preparing, processing, and sustaining provider contracts, contract upload, CIS selection, and fee schedule maintenance. Collaborates closely with operational and market leaders to resolve any escalation or conflict, acting as a single point of contact for provider activation issues. Maintains standard as the subject matter expert for all things provider activation across all group and provider types (e.g., ancillaries, hospital systems, individual providers, groups, facilities, FQHCs/RHCs). Works with compliance and quality assurance teams to ensure all relevant quality standards operational policies/procedures are aligned with the strategic objectives and ensures legislative and policy compliance relative to provider activation functions. Controls the continuous improvement roadmap for provider activation operations including identifying projects to improve. Will build and implement the strategy to partner with our vendors. Works closely with leadership to identify and report on SLAs and overall team performance against SLAs. Embraces and leads with digital ways of working and utilizes latest industry technologies and methodologies.

Use your skills to make an impact
 

Required Qualifications

5 or more years of leadership experience leading operation teams5 or more years of provider contract administration experience related to directories and claims paymentBachelor’s DegreeStrong knowledge in process improvement and data-driven performance managementExecution-driven mindset with an openness to collaborate and present material to internal leadership teamsExcellent verbal and written communications with the ability to align the organization on streamlined processes using various change management techniques

Preferred Qualifications

3 or more years of experience leading other leadersKnowledge of Humana's internal policies, procedures, and systems

Additional Information

Location: Remote US, prefer Louisville, KY area

Hours: Typical Business Hours (9am to 5pm EST respectively)

Travel Requirement: Up to 10% travel may be required

Work at Home Statement:

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 recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

HireVue statement:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Scheduled Weekly Hours

40

Pay 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.

 

$123,800 - $170,400 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

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.