Provider Engagement Specialist — Indiana Healthcare Network

Humana; Butlerville (IN); Remote; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Provider Engagement Professional to build and grow long-term relationships with physicians, providers and healthcare systems within Humana's Healthy Horizons in Indiana's Medicaid Plan. You will manage onboarding, education, and provider inquiries, supporting both physical and behavioral health providers in Indiana.

You will report to the Provider Engagement Manager and may travel up to 25% as needed.

Qualifications

• Requires 2+ years in health care or managed care with physical/behavioral health providers.
• Experience in training and educating providers.
• Experience with formal presentations using PowerPoint.
• Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution.
• Knowledge of Microsoft Office applications such as Excel (pivot tables, macros).

Responsibilities

• Serve as primary relationship manager with physical and behavioral health providers to ensure positive provider experience.
• Conduct trainings and education with assigned providers, including annual trainings.
• Support onboarding of new providers with orientation sessions.
• Respond to provider inquiries and resolve issues with enterprise teams (claims, authorizations, referrals).
• Coordinate regional provider townhalls and trainings.
• Communicate updates on Humana policies and Indiana program updates.
• Work with internal resources and systems (claims, reimbursement, enrollment).
• Ensure compliance with Indiana managed care contractual requirements for provider relations.

Skills

Relationship management

Training delivery

PowerPoint

Excel proficiency

Communication

Education

Bachelor's Degree

Tools

PowerPoint

Excel (Pivot tables)

Job description

Humana is seeking a Provider Engagement Professional to build and grow long-term relationships with physicians, providers and healthcare systems within Humana's Healthy Horizons in Indiana's Medicaid Plan. You will manage onboarding, education, and provider inquiries, supporting both physical and behavioral health providers in Indiana.

You will report to the Provider Engagement Manager and may travel up to 25% as needed.