- Our Department of Defense Contract requires U.S. citizenship for this position
- Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
- HGB is not authorized to do work in Puerto Rico per our government contract.We are not able to hire candidates that are currently living in Puerto Rico.
- Position is hybrid - at home/in office, it will require a candidate to either live within a 1 hour commute of Fort Drum, NY or be willing to relocate to this area. This position will be required to come into the office at Fort Drum, 3 days a week. It may also require travel to other locations in the area.
- Bachelor's degree
- 5 years of leadership and management experience
- Experience with fiscal stewardship or responsibility for managing cost trends
- Experience coordinating the activities of diverse functions
- Network management and development experience
- Managed care experience
- Ability to analyze data and make informed recommendations
- Proven track record in developing working relationships and influencing throughout the matrix environment
- Proficient with Microsoft office products to include Word, Excel and Outlook
- Master's Degree with concentration in Nursing, Healthcare Administration or other related field
- MCG Criteria knowledge and prior clinical experience in direct patient care
- Experience in TRICARE or other Federally regulated healthcare programs
- Experience in the military health system
- 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
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Market Development Advisor - Albany, United States - Humana
Description
Become a part of our caring community and help us put health firstAre you looking to join a team where you can be a part of our important mission of supporting the TRICARE healthcare program for our nation's military? Humana Government Business is a top 10 Department of Defense contractor, with a long history in the TRICARE business and has recently been awarded the T-5 East Region, the next generation of military health contracts. The Market Development Advisor is part of a team that is responsible for military health system operations and optimization including contractual performance and provider network management in order to provide the best experience for our TRICARE beneficiaries and providers.
This position will be a hybrid office position - required to come into the office at Fort Drum, NY 3 days a week and work at home the other days.
The Market Development Advisor has full responsibility and accountability for the daily administration and management of the TRICARE contract within their assigned geography. This critical role links local market-centric operational and tactical actions to success of the business strategies and goals of Humana Military, the Defense Health Agency (DHA), Defense Health Networks (DHNs) and Military Treatment Facilities (MTFs). Oversees day-to-day TRICARE activities within a territory that includes designated Prime Service Areas (PSAs), Non-Prime Service Areas (NPSAs), MTFs, Coast Guard clinics, and National Guard and Reserve Units. Provides consultative services to DHN and MTF personnel to create and sustain a local high-quality integrated healthcare system congruent with the Military Health System (MHS) Quadruple Aim. Collects and analyzes data to develop, influence, and implement strategies and courses of action that support and improve DHN/MTF optimization, a ready medical force and medically ready service members. Directs daily TRICARE service delivery and network operations to include customer support and outreach activities, network adequacy, access to care standards, provider relationships, provider education, and provider management within the defined geographic area.
Performs or oversights the timely and comprehensive review and response to TRICARE inquiries, and researches and resolves complaints, issues and concerns from beneficiaries, providers, and Government personnel. Actively participates in the development and deployment of Alternative Payment Methodologies and Demonstration Pilots aligned to Value Base Care models. Serves as the primary TRICARE point of contact for designated MTF Directors and their staff, beneficiaries who reside in the area, and community providers. Partners with community agencies to connect military families with local programs that target and enhance military health and resilience. Acts in the absence of the Market Director as requested and performs other duties as assigned. This position may require travel and work during uncommon duty hours to conduct oversight and outreach activities.
Use your skills to make an impact
Required Qualifications
Work at Home Requirements
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.
$93,000 - $128,000 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.
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 because he or she is a protected veteran. It is also the policy of Humanato 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.
