Senior Network Performance Professional

As a Senior Network Performance Professional at Humana in Phoenix, Maricopa County, you will work full‑time to strengthen provider partnerships and elevate outcome metrics that support better health outcomes for members.

About the Role

This position sits within Humana’s network operations team, focusing on the strategic improvement of provider outcomes across key quality programs. You will collaborate with clinical and administrative stakeholders to translate data insights into actionable plans that boost Star ratings and overall network effectiveness.

What You'll Do

• Analyze provider outcomes data, including claims, utilization, and quality measures, to identify improvement opportunities.
• Develop and execute performance improvement initiatives in partnership with physicians, hospitals, and ancillary service providers.
• Monitor progress against established goals, preparing regular reports for leadership and provider partners.
• Facilitate workshops and training sessions that educate providers on Star criteria and best practices for quality improvement.
• Maintain strong relationships with network contacts, serving as the primary point of contact for outcomes‑related inquiries.
• Stay current with CMS guidelines, industry benchmarks, and emerging trends that impact network outcome metrics.

What We're Looking For

• Bachelor’s degree in healthcare administration, business, public health, or a related field; equivalent work experience considered.
• Minimum of five years of experience in healthcare network management, provider relations, or quality improvement.
• Proven ability to interpret complex data sets and translate findings into clear, actionable recommendations.
• Excellent communication and interpersonal skills, with a track record of building trust among diverse provider groups.
• Experience working with CMS Star ratings, HEDIS measures, or similar quality performance programs.
• Proficiency with data analysis tools (e.g., Excel, SQL, Tableau) and project management methodologies.
• Self‑motivated, detail‑oriented, and capable of managing multiple priorities in a fast‑paced environment.

About Humana

Humana is a leading health and well‑being company committed to helping people achieve lifelong health through integrated care, innovative services, and a compassionate approach. Our network professionals play a vital role in ensuring that members receive high‑quality, coordinated care from trusted providers across the communities we serve.

How to Apply

To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.