LTSS Provider Representative

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish and nurture relationships with Home and Community-Based Services (HCBS) and Long-Term Services and Supports (LTSS) providers through email, phone interactions, and face-to-face visits.

• Communicate program updates, administrative modifications, and training opportunities.

• Assist providers in resolving claims, service, and operational challenges by liaising with internal teams.

• Perform site visits to evaluate readiness, ensure network adequacy, and address the needs for timely service initiation and access.

• Collaborate with contracting and other departments to attract, onboard, and retain LTSS providers.

• Lead or engage in educational sessions, webinars, and office hours for providers.

• Oversee provider contract compliance, reimbursement policies, and adherence to state and regulatory requirements.

• Aid in developing provider recruitment strategies to fulfill network requirements in designated regions.

• Offer data and insights during contract negotiation processes.

• Represent the organization at provider seminars or presentations for state Medicaid agencies and provider associations.

⛳️ Requirements

• Bachelor's degree is preferred.

• Minimum of 3 years of customer service experience in a provider setting or as a trainer.

• An equivalent combination of education and experience is acceptable.

• Excellent communication, organizational, and accountability skills.

• Ability to work effectively in a team-oriented environment.

• Experience collaborating directly with providers to formulate strategies that enhance outcomes.

• In-depth knowledge of Medicaid LTSS claims.

• Proficient in Microsoft Office, particularly PowerPoint and Excel.

• Comfortable delivering presentations to groups of varying sizes.

• Previous experience in community or home care settings.

🏝️ Benefits

• Comprehensive health coverage options.

• Retirement savings plan with employer contributions.

• Opportunities for professional development and career advancement.

• Flexible work schedules to promote work-life balance.

• Employee assistance programs for personal support.