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The Director, Provider Education develops and leads initiatives, strategies, and processes focused on enhancing provider knowledge of Medicare and Medicaid quality and risk-adjustment programs. They help ensure success in these programs by working in close collaboration with regional market teams. The Director, Provider Education is a key leader on the Provider Support Team within the Healthcare Quality Reporting and Improvement organization. They report to the National Medical Director and lead a diverse team driving education strategy and execution.

The Director, Provider Education drives success in risk adjustment and Stars by innovating and executing provider-education focused initiatives and activities. They oversee the development and training around associated provider programs and educational resources. They analyze data and practice trends to identify the greatest education opportunities. They support provider-facing presentations and education materials. They lead innovations in education delivery including market optimization technological solutions, novel education vehicles, and appropriate engagements with solutions partners. They help support compliance with continuing medical education requirements for physician-focused education, and continuing education unit requirements for medical coders. They have close engagement with legal and compliance teams to ensure all efforts meet regulatory requirements. They oversee a diverse and evolving team and have the ability to lead through change. They work independently and autonomously with minimal need for direct oversight. They are a strong team-player, engaging leaders and associates across the enterprise to drive success in education outcomes. They independently identify and deliver on goals and performance metrics.

Leading: Direct reports for leaders and teammates within the Provider Education Execution and Strategy teams.

Provider Education Execution Responsibilities:

· Lead the development of provider education programs focused on Medicare Risk Adjustment and Stars

· Collaborate with Market Associates to drive highest-impact educational opportunities

· Analyze provider and market performance indicators to tailor education interventions

· Lead the creation of provider-facing Webinars and other educational materials

· Support Continuing Medical Education offerings for Medicare Risk Adjustment and Stars

Provider Education Strategy Responsibilities:

· Oversee the development and execution of provider education enhancements

· Lead Market Coding Education optimization programs

· Strategize new provider education channels (e.g. EHR integration, videos, just-in-time trainings, etc.)

· Integrate education offerings across HQRI-wide priorities and innovations

Medical Director Support Responsibilities:

· Work autonomously, providing leadership and operational direction to the Provider Education Team

· Be the leader and primary point of contact for provider education initiatives

· Support the development of associates on the Education team and fulfill day-to-day leadership responsibilities

· Engage the Medical Director whenever additional leadership or clinical support is needed

Use your skills to make an impact

Required Qualifications

• Bachelor’s Degree
• 5 or more years of management experience with proven skills leading an evolving team
• Familiarity and experience educating providers in Value Based Care principles, including Medicare Risk Adjustment & Stars
• Ability to work and lead independently with minimal oversight
• Experience working with and supporting initiatives under the direction of senior leadership
• Experience developing and implementing novel strategies, pilots, or projects
• Ability to manage multiple or competing priorities and work in a fast-paced environment with changing priorities
• Strong knowledge of Microsoft Office XP products (Word, Excel, Access)
• Excellent communication skills both oral and written
• Proficiency in analyzing and interpreting data trends and continuous quality improvement process

Preferred Qualifications

• Master’s Degree (MBA or similar)
• Coding certification (CPC or equivalent) or ability to obtain if requested
• Familiarity and experience with health data interoperability

Additional Information

Location: Remote with up to 10% travel

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.

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
• Associates 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 associates 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 Alert Statement

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.

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.

$138,900 - $191,000 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.Application Deadline: 11-06-2025

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.

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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.