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Job Details

Provider Relations Professional - Remote/Field LA

Location
Belle Chasse, LA, United States

Posted on
Sep 06, 2022

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Profile

Description

The Provider Relations/Engagement Professional 2 develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Provider Relations/Engagement Professional 2 will be responsible for:


Visiting w/Provider face to face and virtual, educating providers on policies and processes, building relationships, educating providers on the use of online tools and resources, monitoring reports and documenting provider encounters
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Follows established guidelines/procedures.


Required Qualifications


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
Intermediate to advanced computer skills and experience with Microsoft Word, Excel, Outlook and Power Point
Strong verbal and written communication skills
Strong organization and prioritization skills
Experience working with Providers Office, Hospitals, Conferences, Seminars, Town Halls and other community based events
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
Must be available to work a flexible schedule for Association Events otherwise the schedule will be Monday - Friday and require a minimum of 3-4 days travel a week in your local area
Training date 10/10/22


Work-At-Home Requirements


Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Travel


This position will require a minimum of 3-4 days a week in your local area
Must have a Valid driver's license with reliable transportation and the ability to travel within the state, as required
This role is part of Humana's Driver safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.


Preferred Qualifications


Experience with Physical or Behavioral Health
Working with Louisiana Medicaid
Comprehensive knowledge of Medicaid policies, processes, and procedures


Additional Information

Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov) (****opinion)

#LI-KK1

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****

Company info

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