Senior Network Optimization Professional

Job description

Become a part of our caring community The Senior Network Optimization Professional ensures Humana’s Michigan Medicare/Medicaid provider network meets compliance standards and delivers value. Responsibilities include analyzing network performance, supporting provider contracting decisions, collaborating to resolve operational issues, and advising on network strategy. This position reports to the Network Optimization Principal. The Senior Network Optimization Professional drives network optimization and value and managing compliance with network requirements - including network adequacy - for Humana’s Michigan Medicare/Medicaid Integrated plan. The Senior Professional will support the analysis of provider network performance to inform contracting and terminations. They will work closely with the Provider Relations team to understand and address network operational issues. Additionally, they will advise on network composition and value-based payment strategy. This position works on problems of diverse scope and complexity ranging from moderate to substantial. Key Role Objectives: Use your skills to make an impact - Contribute to executing strategy for Humana's Michigan Medicare/Medica...