Provider Relations Representative – LTSS/BH

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

📋 Description

• Act as the main relationship manager for designated LTSS and HCBS providers to ensure a positive experience with Humana Healthy Horizons and encourage network retention.

• Conduct regular meetings, both in-person and online, with assigned providers to provide training and education.

• Assist newly assigned providers with their onboarding process, including organizing orientation session(s).

• Address inquiries from assigned providers and facilitate timely issue resolution.

• Develop provider training materials based on feedback, trends in claims, or changes in processes.

• Inform providers about the location and content of all materials intended for them.

• Organize regular meetings with providers.

• Ensure adherence to all Virginia managed care contractual obligations related to provider relations.

⛳️ Requirements

• Bachelor’s Degree.

• 1 to 5 years of experience in healthcare or managed care, with a focus on Provider Contracting, Network Management, or Provider Relations.

• Proven skills in planning, preparation, and presentation, along with a solid understanding of reimbursement and bonus structures.

• Ability to manage multiple projects simultaneously and meet deadlines.

🏝️ Benefits

• Medical, dental, and vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company and personal holidays.

• Volunteer time off.

• Paid parental and caregiver leave.

• Short-term and long-term disability.

• Life insurance.