Provider Relations Representative – LTSS/BH

GeneralGeneralFull TimeRemoteJuniorTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

Virginia

Posted

18 days ago

Salary

$59.3K - $80.9K / year

Seniority

Junior

Bachelor Degree1 yr expEnglish

Job Description

Provider Relations Representative – LTSS/BH

Humana

• Serve as primary relationship manager with assigned LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention • Meet regularly, both in person and virtually, with assigned providers to conduct training and education • Support newly assigned providers with onboarding, including hosting orientation session(s) • Respond to assigned provider inquiries and support prompt issue resolution • Create provider trainings based on provider feedback, trends in claims or process changes • Educate provider on location and content of all provider facing materials • Convene regular meetings with providers • Ensure compliance with all Virginia managed care contractual requirements for provider relations

Job Requirements

  • 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

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

Related Categories

Related Job Pages

More General Jobs

TreviPay logo

Arbitration Specialist I

TreviPay

The Most Trusted B2B Payments and Invoicing Network

General19 days ago
Full TimeRemoteTeam 501-1,000H1B Sponsor

• Must exemplify TreviPay Mission and Values. • Must meet or exceed department metrics, program Service Level Agreements (SLAs) and department Service Level Standards (SLSs). • Skilled to de-escalate challenging customers, clients or merchants and provide exceptional customer service. Use sound judgement to route escalated requests and unresolved issues to the appropriate team members (e.g.: tier 2 or 3 or Leadership). • Serve as a primary contact to clients, merchants and customers providing timely, accurate and comprehensive responses and resolution to common questions and issues regarding supported programs, systems, processes, and procedures. • Provide feedback and assistance to collaborate with other team members or leadership to improve processes, procedures, new implementations and subsequent training and documentation. • Welcome change and adapt positively to internal and external changes as well as driving change as needed. • Dedicated to actively engage in building rapport with internal and external parties to provide an excellent customer experience resulting in increased program usage. • Illustrate initiative by proactively contacting customers and merchants to address issues (e.g.: rejections, disputes, authorizations, technical needs, potential account issues, etc.) • Complete assigned learning before the due date while actively participating in learning sessions. • Perform other duties as assigned by leadership.

Costa Rica
Cardiovascular Associates of America - CVAUSA logo

Health Coach – Value Based Care

Cardiovascular Associates of America - CVAUSA

Empowering Cardiovascular Specialists to Transform Patient Care

General19 days ago
Full TimeRemoteTeam 51-200Since 2021H1B No Sponsor

• Provide education and coaching related to heart failure, lifestyle modification, medication adherence, nutrition, physical activity, and self-management. • Establish short- and long-term goals with patients using shared decision-making and motivational interviewing techniques. • Encourage sustained patient engagement, self-advocacy, and behavior change throughout program participation. • Partner with the clinical care team to support patient care plans and escalate concerns appropriately. • Provide timely updates and documentation related to patient engagement and progress. • Participate in interdisciplinary team meetings. • Respond to patient communications in a timely, professional, and compassionate manner. • Build and maintain strong, trust-based relationships with patients and caregivers. • Consistently deliver a high-quality patient experience aligned with program standards.

Florida
Olsson logo

Environmental Modeler Specialist – Noise and Air

Olsson

We engineer solutions that improve communities.

General20 days ago
Full TimeRemoteTeam 1,001-5,000Since 1956H1B Sponsor

• Perform noise modeling and analysis for industrial, infrastructure, or environmental projects. • Support air quality modeling and environmental compliance projects, as needed. • Develop and manage modeling inputs using GIS, AutoCAD, and other data sources. • Assist in preparing technical reports and documentation for permits and compliance measures. • Work on environmental modeling / compliance projects and ensure adherence to project scope and schedule. • Support small-scale project management, including monitoring timelines, budgets, and scope under the guidance of senior staff.

Iowa + 4 moreAll locations: Iowa | Kansas | Nebraska | Oklahoma | Missouri
Eximium Talent logo

Psychiatric Mental Health Nurse Practitioner, Texas Licensed

Eximium Talent

Tech Talent Sherpas, supporting and challenging you on your path to growth.

General20 days ago
Full TimeRemoteTeam 1-10Since 2016H1B No Sponsor

• Provide psychiatric evaluations and ongoing medication management for patients across the lifespan (ages 5+). • Develop and implement evidence-based treatment plans that align with patient goals. • Prescribe and manage psychotropic medications, monitoring for efficacy and side effects. • Collaborate with primary care providers and multidisciplinary teams to support whole-person care. • Address co-occurring disorders, including substance use, with a comprehensive, evidence-driven approach. • Maintain timely, accurate documentation in partner-site EHR systems to support care continuity. • Engage patients through telehealth platforms to ensure accessibility and equity in care delivery.

Texas