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You will be part of a caring community at Humana.
When you meet us, you can tell we started as a hometown company. We’re proud of our Louisville roots and, as we’ve grown, that community feeling has spread across all 50 states and Puerto Rico. No matter where you are—whether you’re working from home, from the field, from our offices, or from somewhere in between—you’ll feel welcome here. We’re a caring community made of close-knit teams, cross-country friendships, and inclusive resource groups, all gathered around one big table where everyone’s voice is heard and respected. Community is a verb here. It’s up to each of us to care for it and maintain it. Because the relationships we form will help us deliver better health outcomes for the people we so proudly serve.
Are you Caring, Curious and Committed? If so, apply today!
Responsibilities
Key Role Objectives
- Advise Provider Services Director on strategic and day to day operations of the overall Provider Services team, which includes provider relations, claims education, provider engagement, and practice transformation functions
- Establish infrastructure to measure KPIs and other metrics in order to ensure compliance with related managed care contractual requirements
- Develop initial and manage annual updates of the market’s Provider Support Plan, in partnership with the Director, as well as any other related required state reporting
- Oversee provider communications (fax blasts, emails, bulletins, website or provider portal content updates) end to end process, including development of content and management through the approval process
- Manage provider training and education strategy, including advising on and/or creating market-based provider materials and contributing to provider manual and required training materials
- Prior to market go-live, contribute to implementation of contractual requirements and day-to-day business processes/functions
- Lead process development or improvement and rollout to team members in order to drive efficiencies, standardization, and best practices for [state]
- Drive development of ad hoc strategic initiatives to execute on the Medicaid LTSS/HCBS Provider Journey, Provider Relationship Management model, and other strategic initiatives
- Facilitate workgroup calls/meetings/discussions to ensure successful execution of Provider Support Plan
- Partner with corporate Medicaid Provider Services team to rollout new segment-wide process or technology enhancements in support of the overall Provider Services team
This is a remote position
#LI-Remote
#LI-MH1
Required Qualifications
- Candidate must be located in or willing to relocate to Oklahoma– position may be based at our office in Oklahoma City or remote within the State
- Bachelor's degree
- 6+ years of related experience, including provider relations or engagement, provider communications and education, and/or related health plan operations
- 2+ years of project management experience
- Strategic thinker with the ability to identify, prioritize, and solve complex business problems
- Strong attention to detail
- Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partners
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Reside in Oklahoma City area
- Master’s degree
- Experience working in Medicaid
- Familiarity with LTSS/HCBS providers and/or DSNP/Medicaid-Medicare integration
- Strong understanding of health plan operations
- Experience operating in a matrixed environment
- Project management certification
Additional Information
- Up to 25% travel required
Work at Home Guidance
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 suggested
- 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
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward 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 via 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 anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
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