Provider Relations Representative – LTSS/BH

🔥 0 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $59.3k - $80.9k / year

⏰ Full Time

🟢 Junior

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Serve as primary relationship manager with assigned LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention • Meet regularly, both in person and virtually, with assigned providers to conduct training and education • Support newly assigned providers with onboarding, including hosting orientation session(s) • Respond to assigned provider inquiries and support prompt issue resolution • Create provider trainings based on provider feedback, trends in claims or process changes • Educate provider on location and content of all provider facing materials • Convene regular meetings with providers • Ensure compliance with all Virginia managed care contractual requirements for provider relations

🎯 Requirements

• Bachelor's Degree • 1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies • Demonstrated ability to manage multiple projects and meet deadlines

🏖️ Benefits

• medical, dental and vision benefits • 401(k) retirement savings plan • paid time off • company and personal holidays • volunteer time off • paid parental and caregiver leave • short-term and long-term disability • life insurance