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About the role
The Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. You will report to the Provider Engagement Manager. Found on 1752vc Careers, the job board for startup and VC roles.
What they're looking for
- Must reside in Indiana
- Requires frequent travel to providers and Humana locations - up to 25%
- 2+ years of health care or managed care experience working with physical health and behavioral health providers
- Experience with training and educating providers
- Experience with formal presentations using PowerPoint
- Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution
More about this role
The Provider Engagement Professional develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. You will report to the Provider Engagement Manager.
The Provider Engagement Professional is responsible for day-to-day front line relationship management for network providers in Humana's Healthy Horizons in Indiana's Medicaid Plan, including provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. You will support physical and behavioral health providers in their designated region and must be based in Indiana.
Key Role Objectives
- Serve as primary relationship manager with physical and behavioral health 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 trainings and education, including required annual trainings, ensure understanding of Humana policies and procedures, explain Humana systems, etc.
- Support new assigned...
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