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

The LTSS Provider Education & Outreach Representative serves as the primary relationship manager with LTSS and HCBS 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.

+ 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

+ Bachelor's Degree

+ 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

+ Background in Home Community Based Services

+ **Must reside in the Indianapolis IN Metro Area**

Preferred Qualifications

+ Master's Degree

+ 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

Work at Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

+ Satellite, cellular and microwave connection can be used only if approved by leadership.

+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

**Driver's License, Transportation, Insurance** This role is a part of Humana's Driver Safety program and therefore requires and individual to have:

+ Valid state driver's license

+ Proof of personal vehicle liability insurance with at least $100,000/$300,000/$100,000 limits

+ Access to a reliable vehicle

Tuberculosis (TB) screening program

+ This role is considered patient facing and is part of Humana at Home's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

You will be able to respond to the recruiters preferred response method via text, video, or voice technologies. If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication is not missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Travel: While this is a remote position, occasional travel to Humana's 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.

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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.