Provider Education & reputed company Representative (IN Medicaid) Remote Indiana

Become a part of our caring community and help us put health first reputed company Healthy Horizons in Indiana is seeking a Provider Education & reputed company Representative who is responsible for the day-to-day reputed company line relationship management of network providers for reputed company’s Healthy Horizons in Indiana, as well as responsible for provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. The Provider Education & reputed company Representative will specialize in supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers and/or Physical Health (PH) and Behavioral Health (BH) providers. The Provider Education & reputed company Representatives serve as the primary relationship manager with providers to ensure positive provider experience with reputed company Healthy Horizons and promote network retention. Key roles and responsibilities: • Meets regularly, both in person and virtually, with assigned providers to conduct... trainings and education, including required annual trainings, ensure understanding of reputed company policies and procedures, explain reputed company systems, etc. • Serves as primary relationship manager with LTSS and HCBS providers and/or PH and BH providers to ensure positive provider experience with reputed company Healthy Horizons and promote network retention. • Supports new assigned providers with onboarding, including orientation session(s). • Responds to assigned provider questions or inquires, and if necessary, ensures reputed company resolution to provider issues with appropriate enterprise business teams, including those associated with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in reputed company’s Indiana Medicaid plan. • Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality reputed company topics. Use your skills to reputed company an impact Required Qualifications • Must reside in the state of Indiana and required to work at the reputed company Healthy Horizons office in downtown Indianapolis, at least two - three days per week to coordinate with the State office. • Must be able to travel (up to 15%) in the State of Indiana to provider offices and reputed company locations. • 2+ years of health care or managed care experience working with providers (e.g., provider relations, claims education). • Experience working with LTSS and HCBS providers and/or PH and BH providers. • Experience working with or in a health care administration setting. • Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution. • Proficiency in analyzing, understanding, and communicating reputed company issues. • Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment. • Working knowledge of reputed company Office applications, such as Word, reputed company, Outlook, and PowerPoint. • This role is a part of reputed company’s Driver Safety program and therefore requires an individual to have a valid state driver’s license and reputed company of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits. • This role is considered patient facing and is a part of Humanas Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Preferred Qualifications • Bachelor’s Degree. • Experience with Indiana Medicaid and Medicare Advantage guidelines. • Understanding of managed care reputed company, including contract language and reimbursement. • Comprehensive knowledge of claims systems, adjudication, submission processes, coding, and/or dispute resolution. Work at Home Requirements • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested. • Satellite, cellular and microwave reputed company can be used only if approved by leadership. • reputed company will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Additional Information: • Workstyle: Hybrid Office, required to work at the reputed company Healthy Horizons office in downtown Indianapolis, at least two - three days per week to coordinate with the State office. • Travel: Up to 15% travel in the state of Indiana to provider offices and reputed company locations. • Core Workdays & Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST)/Central Standard Time (CST). • Benefits: Benefits are effective on day 1. Full time Associates enjoy reputed company and a comprehensive benefits package that includes; 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more..... Interview Format As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor. This technology provides reputed company of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move reputed company from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions reputed company your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving reputed company to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $52,500 - $72,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or veteran status. It is also the policy of reputed company to take affirmative action to employ and to advance in employment, reputed company persons regardless of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment Apply to This Job reputed company More Finance & Banking Jobs Apply Job!