LTSS Provider Representative

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Professional Management Enterprises (PME)

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

📦 Logistics

🎖️ Defense

Healthcare • Logistics • Defense

Professional Management Enterprises (PME) is a multifaceted professional service and personnel staffing company established in 2006. As a Minority and Service Disabled Veteran Owned Business, PME operates in multiple states, partnering with major corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP. The company specializes in staffing, recruiting, and providing services across various sectors, including healthcare, information technology, and administrative support. PME is a key service provider for the Department of Defense and other Federal Government clients, and it leverages its expertise in healthcare, managed care, IT, and human capital services to deliver flexible and high-performing solutions.

📋 Description

• Build and maintain relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits • Share program updates, administrative changes, and training opportunities • Support providers in resolving claims, service, and operational issues by connecting them with internal teams • Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs • Partner with contracting and other departments to recruit, onboard, and retain LTSS providers • Lead or participate in provider education sessions, webinars, and office hours • Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements • Assist with provider recruitment strategies to meet network needs in assigned regions • Provide data and insights during contract negotiations • Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations

🎯 Requirements

• Bachelor's degree preferred • At least 3 years of customer service experience in a provider environment or as a trainer • Equivalent combination of education and experience accepted • Strong communication, organization, and accountability skills • Comfortable working in a team environment • Experience working directly with providers to develop strategies that improve outcomes • Strong Medicaid LTSS claims knowledge • Proficiency in Microsoft Office, especially PowerPoint and Excel • Comfortable presenting to groups of various sizes • Prior experience in community/home care