Provider Relations Professional

Become a part of our caring community and help us put health first

The Provider Relations/Engagement Professional 2 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. I

You will report to Associate Director Provider Relations and support the Louisiana Medicaid Physical Health team.

In this role as a Provider Relations/Engagement Professional you will be responsible for:

• Conduct in‑person and virtual provider engagements to support education on policies, processes, and available tools, including navigating online resources; monitor relevant reports and document provider interactions following established requirements.
• Support departmental, segment, and organizational strategies by aligning day‑to‑day activities with defined operating goals and cross‑functional programs.
• Plan and execute assigned work, including navigating routine ambiguity, while escalating issues and seek guidance.
• Contribute to programs focused on improving provider and consumer experiences through participation in engagement activities and process awareness. Following established guidelines, procedures, and documentation standards.

Use your skills to make an impact

Required Qualifications

• 1 year of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

• Utilize Microsoft Word, Excel, Outlook, and PowerPoint at an intermediate to advanced level, as evidenced by creating complex documents, spreadsheets, presentations, and email communications required for role functions.

• Successfully demonstrated effective planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies·

• Demonstrated experience conducting face-to-face and virtual meetings with healthcare providers to educate them on organizational policies and processes, foster professional relationships, instruct providers on the use of online tools and resources, monitor relevant reports, and accurately document provider interactions.·

• Demonstrated experience managing multiple projects or assignments concurrently within a professional or academic setting, utilizing structured project tracking or project management tools to monitor progress and ensure completion.

• Prior experience in establishing and maintaining professional relationships with provider offices, hospitals, and community organizations, demonstrated by successful coordination and participation in conferences, seminars, town halls, and other community-based events.

Preferred Qualifications

• Experience working with Medicare/Medicaid or other MCO

Additional Information

Driving Statement

This role is part of our company's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is required.

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana 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

Workstyle: Combination remote work at home and onsite/home member visits

Hours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs and requires approval.

Travel: We will require you to travel for field visits to meet with provider in your Region, based on the Provider tier level (which we will explain during the interview). We have positions available in Region 4, which covers the following parishes in Louisiana: Lafayette, Evangeline, St. Landry, St. Martin, Iberia, Vermillion, and Acadia. We also have positions available in Region 5, which covers the following parishes: Calcasieu, Jefferson Davis, Cameron, Allen, and Beauregard.

Mileage reimbursement is provided for work-related travel. Eligible mileage includes:

• Travel from your home to your first work location of the day.
• Travel between client or assignment locations during the workday.
• Travel from your final work location back to your home.

Additional Information

Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration. For more information please visit: Louisiana Board of Ethics (la.gov)

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$59,300 - $80,900 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

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") 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 outside of work. Among our benefits, Humana 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

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better 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 Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all 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 all levels of employment.