Regional Senior TRICARE Community Liaison

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

📋 Description

• Serve as a representative of Humana Military in managing TRICARE services within a specified East Region territory.

• Offer guidance to nationally contracted healthcare providers and supporting facilities operating in both East and West Regions.

• Build and maintain relationships with providers from National Health Systems and large healthcare organizations.

• Clarify the TRICARE health plan, its policies, regulations, and assist in navigating the Military Health System.

• Effectively manage time, prioritize tasks, address inquiries, and resolve both simple and complex provider-related issues.

• Assist in customer service efforts, conduct outreach, ensure network adequacy, and facilitate access to care.

• Oversee provider relations and educational initiatives in the assigned region.

• Review, investigate, and address TRICARE inquiries, complaints, and issues from beneficiaries, providers, and government staff.

• Aid in the implementation of Alternative Payment Methodologies and Demonstration Pilots that promote value-based care.

• Maintain transparent communication and accountability with all stakeholders.

• Evaluate provider capacity and identify network deficiencies.

• Provide guidance to TRICARE beneficiaries, Medical Treatment Facility personnel, government officials, and civilian healthcare providers.

• Accurately and promptly complete documentation, transaction processing, and reporting.

• Perform additional tasks as requested by the supervisor in alignment with company goals.

⛳️ Requirements

• Minimum of 2 years of experience with TRICARE.

• Background in healthcare provider relations, provider management, provider contract negotiations, or engagement with healthcare providers.

• Proven experience in customer relationship management with polite and professional interactions.

• Ability to analyze information, research issues, and devise and implement effective solutions.

• Outstanding public speaking skills.

• Excellent verbal and written communication abilities.

• Extensive knowledge of Microsoft Office applications, including Word, Excel, OneNote, and Outlook.

• Proficient in maintaining complex spreadsheets using Excel.

• Exceptional organizational skills to juggle multiple tasks.

• Capability to work efficiently and independently without distractions.

• Experience collaborating with diverse stakeholders and teams at various organizational levels.

• U.S. citizenship is mandatory.

• Ability to obtain government security clearance through National Background Investigation Services (NBIS).

• Current residence outside of Puerto Rico is required.

• A bachelor's degree in healthcare administration, business, or a related discipline is preferred.

• Background in managed care, health insurance, or a relevant healthcare sector is preferred.

• Familiarity with TRICARE policies and/or the military healthcare delivery system is preferred.

• Experience interpreting policies and government contracts such as TRICARE, Medicare, Medicaid, or CMS is preferred.

🏝️ Benefits

• Bonus incentive plan based on individual and/or company performance.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability coverage.

• Long-term disability coverage.

• Life insurance.

• Opportunity for remote work.

• Occasional travel to Humana offices for training or meetings.

• Dedicated workspace at home.

• Internet service that meets minimum speed requirements.