Manager, Network Performance
Humana
Become a part of our caring community and help us put health first
As the Manager of Network Performance, you will lead a team of Network Performance Professionals dedicated to improving provider performance and enhancing Stars ratings. Your role is pivotal in fostering a collaborative and supportive environment where your team can thrive. By building and maintaining strong relationships with assigned physician groups, your team will implement strategies and tactics that elevate network performance and increase plan quality. This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will be responsible for guiding, mentoring, and developing your team to achieve their full potential, ensuring that they are equipped with the knowledge and tools necessary to excel in their roles.Key Responsibilities
Team Leadership: Lead a team of provider-facing direct reports, guiding them in their efforts to improve provider performance.
CMS Program Expertise: Serve as the expert on CMS Stars program, HEDIS, CAHPS, and HOS, providing guidance and support to the team.
Provider Solutions: Build and maintain strong relationships with provider practices, leading the team's discussions to find and implement improvement opportunities, develop workflows, and monitor outcomes while focusing on solutions that enhance provider engagement.
Performance Metrics: Inform and lead the team based on enterprise, regional, and departmental KPIs and OKRs, ensuring alignment with organizational goals and objectives.
Cross-Departmental Collaboration: Partner with other departments to advance performance in Provider Engagement, Stars Improvement, MRA, Interoperability, Clinical, Corporate Partners, and Provider Contracting to improve provider/member engagement. Leads interdepartmental and team
strategy meetings.
Data Driven-Insights: Ingest data from various sources, analyze it, and inform the team and leadership of learnings.
Educational Initiatives: Create data-supported, focused education to drive team tactics and improve performance.
Solution Focus: Direct the team's focus toward solutions that maximize provider abilities to engage effectively.
Leadership Decisions: Own decisions related to people leadership, resources, strategic planning, and tactical operations for the team.
Performance Review: Review and communicate performance results of the team and initiatives.
Culture and Engagement: Articulate and model desired culture attributes, actively supporting team engagement, performance, well-being improvement plans, and team activities.
Use your skills to make an impact
Required Qualifications
Bachelor’s Degree in Business, Finance, Healthcare, or a related field, or equivalent experience.
Prior Medicare experience & understanding of value-based care model.
Knowledge of HEDIS/Stars and CMS quality measures.
Proficiency in analyzing and interpreting healthcare data and trends.
Demonstrated capability with leading, coaching, and developing associates formally or informally (training, SME, etc).
Strong communication and presentation skills, both verbal and written, with experience presenting to internal and external customers, including high-level leadership.
Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care.
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
Must be able to work according to Mountain Time Zone and/or Pacific Time Zone hours.
Preferred Qualifications
Master’s Degree in Business, Finance, Health Care/Administration, Nursing, or a related field
Progressive management experience, leading and developing others.
Progressive experience in the health solutions industry, particularly with interoperability.
Prior managed care or Medicaid experience.
Background working in quality improvements, MRA.
Lives within the region where the work is located.
Additional Information
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.
Work At Home / Internet Information:
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.
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.
SSN Information:
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.
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.Application Deadline: 06-17-2025
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 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.