Provider Engagement/Relations Manager
Humana
full-time
Posted on:
Location Type: Remote
Location: Oklahoma • United States
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Salary
💰 $86,300 - $118,700 per year
About the role
- Lead, coach, and develop a team responsible for serving as the primary point of contact for physical and behavioral health providers in the Oklahoma Medicaid network.
- Oversee the planning and execution of regular in-person and virtual meetings with providers to deliver training, education, and orientation regarding Humana policies, procedures, and systems.
- Ensure new providers receive effective onboarding support, including orientation sessions and timely access to necessary resources.
- Supervise the team's response to provider questions and inquiries, ensuring prompt and accurate resolution in collaboration with internal enterprise business teams (e.g., claims, prior authorization, referrals, provider education).
- Guide the coordination and facilitation of Service Operating Committee meetings with providers, ensuring effective agendas, materials, and cross-functional participation (clinical, provider engagement, etc.).
- Ensure timely and clear communication of updates regarding Humana’s policies, procedures, and Oklahoma’s SoonerSelect program to network providers.
- Direct the planning and execution of regional provider townhalls and trainings to promote engagement and satisfaction.
- Collaborate with internal operational teams (e.g., claims, reimbursement, provider enrollment) to support high-quality provider interactions.
- Monitor and enforce compliance with Oklahoma managed care contractual requirements, including provider relations processes such as claims dispute resolution within required timeframes.
- Use data, feedback, and performance metrics to identify trends and implement continuous improvement strategies for provider engagement and retention.
- Represent the Provider Relations function in cross-departmental meetings and initiatives as needed.
Requirements
- Must reside in Oklahoma
- 4+ years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
- 2+ years of demonstrated management experience and partnering with senior leadership on strategic initiatives
- Proven planning, preparation and presentation skills, with established knowledge of reimbursement and bonus methodologies
- Demonstrated ability to manage multiple projects and meet deadlines
- Comprehensive knowledge of all Microsoft Office applications
- Ability to travel, as needed
Benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
provider contractingnetwork managementprovider relationsreimbursement methodologiesbonus methodologiesproject managementdata analysisperformance metricscontinuous improvement strategies
Soft skills
leadershipcoachingcommunicationplanningpresentationcollaborationproblem-solvingtime management