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Humana

Manager, Network Performance

Posted 4 hours ago
$94900 - $130K per year
2-5 years experience
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AI Summary

The Manager of Network Performance leads a team to partner with physician groups to improve quality and operational measures, including Medicare Stars. They oversee performance monitoring, drive strategic initiatives, and collaborate across various business departments to enhance network effectiveness.

Become a part of our caring community
 

The Manager of Network Performance leads a team of professionals dedicated to partnering with providers to improve performance on key quality and operational measures, including Medicare Stars. Through strategic collaboration and strong relationships with assigned physician groups, this leader drives initiatives that enhance provider performance, strengthen network effectiveness, and improve overall plan quality and member outcomes.

Key Responsibilities

  • Lead and develop a team of provider-facing associates.
  • Serve as subject matter expert on CMS Stars, HEDIS, CAHPS, HOS.
  • Oversee team’s external discussions with provider partners to drive performance improvement, workflow optimization, and outcome monitoring. 
  • Collaborate across Provider Engagement, Stars, MRA, Interoperability, Clinical, Provider Contracting, Leadership, and other business partners.
  • Align team priorities and execution with enterprise, regional, and departmental KPIs and OKRs.
  • Lead cross-functional meetings and strategic initiatives.
  • Analyze data, identify insights and opportunities, and communicate findings to leadership and the team.
  • Develop data-driven education and resources to support team performance.
  • Oversee daily operations and strategic execution for direct reports.
  • Monitor and report team and initiative performance results.
  • Foster a strong culture of engagement, well-being, and professional development.


Use your skills to make an impact
 

Required Qualifications

  • 3-5 years progressive experience in the payer, healthcare, provider relations, quality improvement or related space with demonstrated success in driving performance in complex healthcare environments
  • Prior Medicare experience with a strong understanding of value-based care models, provider performance improvement, and quality-focused healthcare delivery including but not limited to HEDIS/Stars, Interoperability, and Medicare Risk Adjustment
  • Proven ability to analyze and interpret healthcare data, identify trends and opportunities, and translate insights into actionable strategies that drive measurable improvement.
  • Experience leading, coaching, mentoring, or developing associates, including training and subject matter expertise
  • Must be able to work during 8-5pm EST/CST
  • Must live within the region [Alabama, Louisiana, Mississippi, or Tennessee]

Preferred Qualifications

  • Bachelor’s degree in business, finance, healthcare, or related field, or equivalent experience
  • Management experience, leading and developing others
  • Progressive experience in the health solutions industry
  • Prior managed care or Medicaid experience

Additional Information

This role is "remote/work at home", however, you must live within the region (Alabama, Louisiana, Mississippi, or Tennessee) to be considered for this opportunity.

Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

 

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

 

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.


 

$94,900 - $130,500 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


About us
 

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

​
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

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