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.
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 InformationThis 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 Hours40
Pay RangeThe 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 BenefitsHumana, 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.
