Remote Provider Engagement Specialist

Humana; Indianapolis (IN); Remoto; USD 59.000 - 81.000; Tempo pieno

Descrizione del lavoro

Humana is seeking a Provider Engagement Professional to develop and grow positive relationships with physicians, providers and health systems within Humana Healthy Horizons Indiana Medicaid. You will manage onboarding, training, and day-to-day inquiries while working remotely from Indiana.

You will travel to provider sites up to 25% of the time, conduct trainings, support enrollment and renewals, and ensure compliance with Indiana managed care requirements.

Competenze

• Must reside in Indiana.
• Travel up to 25% to provider sites and Humana locations.
• 2+ years of health care or managed care experience with physical/behavioral health providers.
• Experience with 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 (Excel, pivot tables, macros).

Mansioni

• Serve as primary relationship manager with physical and behavioral health providers to ensure positive provider experience and retention.
• Conduct trainings and education with assigned providers, including required annual trainings.
• Assist with onboarding of new providers, including orientation sessions.
• Respond to provider questions and coordinate prompt resolution with enterprise teams (claims, authorizations, referrals).
• Convene Service Operating Committee meetings with providers and relevant teams.
• Communicate updates on Humana policies and Indiana programmatic changes.
• Coordinate regional provider townhalls and trainings.
• Collaborate with internal resources (claims, reimbursement, enrollment).
• Ensure compliance with Indiana managed care contractual requirements and timely dispute resolution.

Conoscenze

Healthcare experience

Provider training

Presentations

Formazione

Bachelor's Degree

Strumenti

PowerPoint

Excel

Descrizione del lavoro

Humana is seeking a Provider Engagement Professional to develop and grow positive relationships with physicians, providers and health systems within Humana Healthy Horizons Indiana Medicaid. You will manage onboarding, training, and day-to-day inquiries while working remotely from Indiana.

You will travel to provider sites up to 25% of the time, conduct trainings, support enrollment and renewals, and ensure compliance with Indiana managed care requirements.