[Remote] Provider Education and Outreach Rep

Note: The job is a remote job and is open to candidates in USA. Humana Inc. is committed to putting health first, and they are seeking a LTSS Provider Education & Outreach Representative to manage relationships with network providers in Indiana's Healthy Horizons Medicaid market. This role involves provider onboarding, training, and addressing inquiries to ensure a positive provider experience.

Responsibilities

• Meets regularly, both in person and virtually, with assigned providers to conduct trainings and education, including required annual trainings, ensure understanding of Humana policies and procedures, explain Humana systems, etc
• Supports new assigned providers with onboarding, including orientation session(s)
• Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in Humana’s Indiana Medicaid plan
• Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics

Skills

• 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
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Background in Home Community Based Services
• Must reside in the Indianapolis IN Metro Area
• Valid state driver's license
• Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits
• Access to a reliable vehicle
• Tuberculosis (TB) screening program
• Master's Degree
• Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
• Comprehensive knowledge of Medicare policies, processes and procedures

Benefits

• 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

Company Overview

Company H1B Sponsorship