Provider Education and Outreach Rep

Humana • Indianapolis, IN

1d • Remote

About The Position

Become a part of our caring community and help us put health first Humana Healthy Horizons in Indiana is seeking a LTSS Provider Education & Outreach Representative (Provider Engagement Professional 2) who is responsible for the day-to-day front line relationship management of network providers in Humana’s Healthy Horizons Indiana Medicaid market, as well as responsible for provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. The Provider Education & Outreach Representative will specialize in supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers based in Indiana. The LTSS Provider Education & Outreach Representative serves as the primary relationship manager with LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention. Key roles and 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. Use your skills to make an impact

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
• 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

Nice To Haves

• 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

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.

Benefits

• Humana provides 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 and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees