Enable America Jobs

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

Humana Healthy Horizons in Indiana is seeking a Provider Services Advisor (Market Development Advisor) who will be responsible for the strategic and tactical support of the Provider Services team. The Provider Services Advisor will advise the Director, Provider Services, on the day-to-day and strategic operations of the team, process development, and improvement to drive standardization and efficiencies across the team. The Advisor will complete related state reports, develop, and execute upon a provider communication and provider materials development strategy.

Initially, the Provider Services Advisor will play a key role in supporting new market implementation activities and will partner cross-functionally within the market and across the enterprise on matters of significance.

The Provider Services Advisor responsibilities include:

• Advises 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.

• Establishes infrastructure to measure Key Performance Indicators (KPIs) and other metrics to ensure compliance with related managed care contractual requirements.

• Develops initial and manages annual updates of the market's Provider Support Plan, in partnership with the Director, as well as any other related required state reporting.

• Oversees provider communications (fax blasts, emails, bulletins, website, provider webinars, or provider portal content updates) end to end process, including development of content and management through the approval process.

• Manages 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, contributes to implementation of contractual requirements and day-to-day business processes/functions.

• Leads process development or improvement and communicates them to team members to drive efficiencies, standardization, and best practices for Indiana.

• Drives development of ad hoc strategic initiatives to execute on the Medicaid Long-Term Services and Support (LTSS)/Home and Community Based Services (HCBS) provider journey, provider relationship management model, and other strategic initiatives.

• Facilitates workgroup calls/meetings/discussions to ensure successful execution of Provider Support Plan.

• Partners with corporate Medicaid Provider Services team to rollout new segment-wide process or technology enhancements in support of the overall Provider Services team.

Use your skills to make an impact

Required Qualifications

• Must reside in the State of Indiana and be able to travel within the state.

• Required to work in the Indianapolis office two to three days per week to coordinate with the State office.

• 10+ years of related experience, including provider relations or engagement, provider communications and education, and/or related health plan operations.

• 2+ years of successful project management experience.

• Proven experience writing and delivering presentations to large and small provider groups, members of leadership teams, and internal business partners.

• Strategic thinker with the ability to identify, prioritize, and solve complex business problems.

• Advanced knowledge and experience using Microsoft Office and other applications, to include Excel, Word, Outlook, PowerPoint, Zoom, and SharePoint systems.

• This role is a part of Humana's Driver Safety program and therefore requires an individual to have a valid state driver's license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.

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 connection is suggested.

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

• 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.

Preferred Qualifications

• Master's Degree.

• Experience working in Medicaid.

• Familiarly with LTSS/HCBS providers and/or DSNP/Medicaid-Medicare integration.

• Strong understanding of health plan operations.

• Experience operating in a matrixed environment.

• Project Management Professional (PMP) certification.

Additional Information:

• Workstyle: Hybrid Office, required to work at the Humana Healthy Horizons office in downtown Indianapolis two to three days per week to coordinate with the State office.

• Travel: Up to 15% travel in the state of Indiana to provider offices and Humana locations.

• Core Workdays & Hours: Typically, Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST).

• Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay 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 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

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.$93,000 - $128,000 per yearThis 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 because he or she is a protected veteran. It is also the policy of  Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.