Provider Education Specialist Jobs

Three (3) or more years of leadership experience leading a team of direct reports.

Proven interpersonal, organizational, written, and oral communication and presentation skills.

Experience operating in a matrixed environment and coordinating across various departments.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Understanding of learning design principles and proven application of those principles to create easy-to-read and captivating provider training and educational materials.

Experience with establishing a new team and/or new processes.

Stellar interpersonal, communication, and planning skills along with critical thinking and good decision-making abilities.

Strong Leadership and Business Development skills.

Bachelor's Degree or related work experience.

3+ years of prior mobility experience.

Act as the primary point of contact between AppDirect and our Level 1 Providers in Telco.

Proactively creates and executes on annual business plans to achieve growth goals.

Facilitate training to the Clients, staff and management

Monitor and prioritize open requests submitted into Jira Service Management to ensure all are resolved in a timely manner

Project manage provider implementations and initiatives

Gather, analyze and document business and system requirements in a formalized manner

Ability to analyze and troubleshoot technical issues and offer innovative solutions

Basic SQL select statement knowledge beneficial

Ensures compliance with Indiana’s Managed Care Contractual requirements for provider relations, such as claims dispute resolution within specified timeframes.

Manages teamwork assignments to ensure adequate coverage to meet quality and service levels.

Five (5) years of technical experience with claims systems, adjudication, submission processes, coding, dispute resolution, and/or other related function.

Two (2) years of progressive leadership experience.

Experience reviewing and analyzing large sets of claims data.

Experience working for or with key provider types: primary care, FQHCs, hospitals, nursing facilities, and/or HCBS and LTSS providers.

Ability to manage several different projects at different stages with ease

Experience seeing projects through the full life cycle

Strong interpersonal skills and extremely resourceful

Drive research projects from start to finish

Determine and define project scope and objectives

Work with PayOps team to determine credit card spend and provider lists

Four (4) or more years of health care or managed care experience working with providers (e.g., provider relations, claims education).

Ensures compliance with Indiana managed care contractual requirements for provider relations, such as claims dispute resolution within specified timeframes.

Exceptional time management and ability to manage multiple priorities in a fast-paced environment.

Assists other Provider Education & Outreach Representatives in the market to address or resolve issues of significant complexity.

Creates and/or delivers trainings and educational materials for LTSS and HCBS providers to serve as resources on Humana processes and procedures.

Experience working with LTSS and/or HCBS providers.

Facilitate training to the Clients, staff and management

Monitor and prioritize open requests submitted into Jira Service Management to ensure all are resolved in a timely manner

Project manage provider implementations and initiatives

Gather, analyze and document business and system requirements in a formalized manner

Ability to analyze and troubleshoot technical issues and offer innovative solutions

Basic SQL select statement knowledge beneficial