Become a part of our caring community and help us put health first
 

Humana Healthy Horizons in Indiana is seeking Provider Education & Outreach Representatives (Provider Engagement Professional 2) who will be responsible for the day-to-day front line relationship management of network providers for Humana’s Healthy Horizons in Indiana, as well as responsible for provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. At least one of the Provider Education & Outreach Representatives will specialize in supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers.

The Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention.

Key roles and responsibilities:

• Meets regularly, both in person and virtually, with assigned providers to conduct trainings and education, including required annual trainings, ensure understanding of Humana policies and procedures, explain Humana systems, etc.
• For the Provider Education & Outreach Representatives specializing in LTSS and HCBS providers, serves as primary relationship manager with LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention.
• Supports new assigned providers with onboarding, including orientation session(s).
• Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in Humana’s Indiana Medicaid plan.
• Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics.

Use your skills to make an impact
 

Required Qualifications

• Bachelors Degree or equivalent experience
• Must currently reside in the Indianapolis IN metropolitan area
• 1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
• Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
• Demonstrated ability to manage multiple projects and meet deadlines
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Masters Degree
• Experience in the Medicaid/Medicare market
• 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

Additional Information

Travel: While this is a remote position, occasional travel to Humanas offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$59,300 - $80,900 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our 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.

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.