Oklahoma Provider Engagement Specialist

Humana Inc; Oklahoma; Hybrid; USD 59,000 - 81,000; Full time

Benefits offered by this job

Medical benefits

401(k) plan

Paid time off

Job summary

Humana Inc. in Oklahoma is seeking a Provider Engagement Professional 2 to develop and nurture positive relationships with physical and behavioral health providers within Humana Healthy Horizons Oklahoma Medicaid.

You will onboard, educate, respond to inquiries, and resolve issues to support performance and member care. The role requires regular provider trainings, onboarding support, and collaboration with internal teams.

Qualifications

• 2+ years of health care or managed care experience working with providers.
• Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution
• Must reside in Oklahoma
• Willing to travel up to 50% of the time

Responsibilities

• Serve as primary relationship manager with physical and behavioral health providers to ensure positive provider experience and promote network retention.
• Meet regularly with assigned providers to conduct trainings and education, including required annual trainings.
• Support new assigned providers with onboarding, including orientation sessions.
• Respond to provider questions or inquiries, and coordinate prompt resolution with enterprise teams (claims, prior authorizations, referrals) and related education.
• Convene Service Operating Committee meetings with providers and team members to discuss operational, clinical, and quality topics.
• Communicate updates on Humana’s policies and Oklahoma SoonerSelect programmatic updates.
• Coordinate regional provider townhalls and trainings.
• Work with internal resources and systems to provide the Perfect Experience in all provider interactions.
• Ensure compliance with Oklahoma’s managed care contractual requirements for provider relations, including dispute timelines.

Skills

Provider relations

Claims education

Interpersonal skills

Travel willingness

Education

Bachelor’s Degree

Tools

Claims systems

Job description

Humana Inc. in Oklahoma is seeking a Provider Engagement Professional 2 to develop and nurture positive relationships with physical and behavioral health providers within Humana Healthy Horizons Oklahoma Medicaid.

You will onboard, educate, respond to inquiries, and resolve issues to support performance and member care. The role requires regular provider trainings, onboarding support, and collaboration with internal teams.