Remote Provider Engagement & Onboarding Specialist

Humana; United States; Remote; USD 59,000 - 81,000; Full time

Job summary

Humana is seeking a Provider Relations Representative to manage day-to-day relationships with LTSS and HCBS providers in the Virginia Medicaid network. You will support onboarding, training, and inquiry resolution, ensuring exceptional provider experiences and adherence to Humana policies.

The role requires residing in Virginia, strong problem-solving, and project management skills, with occasional travel for training or meetings.

Qualifications

• Bachelor's degree or 1-5 years in health care/ managed care with related experience.
• Proven planning, preparation and presenting skills with reimbursement knowledge.
• Ability to manage multiple projects and meet deadlines.

Responsibilities

• Manage day-to-day provider relationships for LTSS/HCBS in Virginia.
• Conduct trainings and education sessions, including annual trainings and policy updates.
• Onboard new providers and host orientation sessions.
• Respond to inquiries and resolve issues with coordination across teams.
• Collaborate with claims, reimbursement, enrollment to ensure a positive provider experience.
• Create trainings from feedback and educate providers on materials and resources.
• Organize meetings, agendas, minutes with clinical and provider engagement teams.
• Educate on processes including claims, authorizations, referrals, and records management.

Skills

Provider relations

Training

Education

Interpersonal skills

Relationship management

Multitasking

Education

Bachelor's degree

Tools

Availity

Provider enrollment systems

Reimbursement systems

Job description

Humana is seeking a Provider Relations Representative to manage day-to-day relationships with LTSS and HCBS providers in the Virginia Medicaid network. You will support onboarding, training, and inquiry resolution, ensuring exceptional provider experiences and adherence to Humana policies.

The role requires residing in Virginia, strong problem-solving, and project management skills, with occasional travel for training or meetings.