Provider Engagement/Relations Manager

Humana

4d • Remote

About The Position

Become a part of our caring community and help us put health first The Manager, Provider Engagement/Relations will lead and support a team of Provider Relationship Managers dedicated to ensuring an exceptional provider experience for Humana Healthy Horizons’ Oklahoma Medicaid plan. This leader will oversee relationship management, provider engagement, training, onboarding, issue resolution, and operational compliance, with the goal of driving provider satisfaction, network retention, and adherence to regulatory requirements.

Requirements

• Must reside in Oklahoma
• 4+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
• 2+ years of demonstrated management experience and partnering with senior leadership on strategic initiatives
• Proven planning, preparation and presentation skills, with established knowledge of reimbursement and bonus methodologies
• Demonstrated ability to manage multiple projects and meet deadlines
• Comprehensive knowledge of all Microsoft Office applications
• Ability to travel, as needed

Nice To Haves

• Bachelor’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

• Lead, coach, and develop a team responsible for serving as the primary point of contact for physical and behavioral health providers in the Oklahoma Medicaid network.
• Oversee the planning and execution of regular in-person and virtual meetings with providers to deliver training, education, and orientation regarding Humana policies, procedures, and systems.
• Ensure new providers receive effective onboarding support, including orientation sessions and timely access to necessary resources.
• Supervise the teams response to provider questions and inquiries, ensuring prompt and accurate resolution in collaboration with internal enterprise business teams (e.g., claims, prior authorization, referrals, provider education).
• Guide the coordination and facilitation of Service Operating Committee meetings with providers, ensuring effective agendas, materials, and cross-functional participation (clinical, provider engagement, etc.).
• Ensure timely and clear communication of updates regarding Humana’s policies, procedures, and Oklahoma’s SoonerSelect program to network providers.
• Direct the planning and execution of regional provider townhalls and trainings to promote engagement and satisfaction.
• Collaborate with internal operational teams (e.g., claims, reimbursement, provider enrollment) to support high-quality provider interactions
• Monitor and enforce compliance with Oklahoma managed care contractual requirements, including provider relations processes such as claims dispute resolution within required timeframes.
• Use data, feedback, and performance metrics to identify trends and implement continuous improvement strategies for provider engagement and retention.
• Represent the Provider Relations function in cross-departmental meetings and initiatives as needed.

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: Manager
• Number of Employees: 5,001-10,000 employees