Provider Relations Representative, LTSS/BH
Humana —Galax, VA
- $59,300 - $80,900 a year
- Full-time
- Mid-level
- Master's degree
- Presentation skills
- Paid parental leave
- Paid holidays
9d
Patient Representative - Orthopedics
Twin County Regional Healthcare —Galax, VA
- $14.41 - $17.79 an hour
- Full-time
- Urgent Care
- High school diploma or GED
- Clinic
- Disability insurance
- Health insurance
Quick Apply
11d
HEDIS Coordinator (Remote Option-NC)
Partners Behavioral Health Management —Elkin, NC
- $52,394.76 - $65,493.45 a year
- Full-time
- Remote
- Customer service
- Writing skills
- Mid-level
- Paid holidays
- Disability insurance
3d
OFFICE ASSISTANT - Northern Urgent Care
NORTHERN REGIONAL HOSPITAL —Mount Airy, NC
- Microsoft Word
- Urgent Care
- High school diploma or GED
- AD&D insurance
- Disability insurance
2d
PATIENT INTAKE COMMUNICATION SPECIALIST
NORTHERN REGIONAL HOSPITAL —Mount Airy, NC
- Customer service
- Computer literacy
- Mid-level
- AD&D insurance
- Disability insurance
10d
Licensed Mental Health Therapist
Headway —Virginia
- Up to $126 an hour
- Remote
- Private practice
- LMFT
- Licensed Clinical Social Worker
Licensed Mental Health Counselor
Headway —Virginia
- Up to $126 an hour
- Remote
- Private practice
- Mid-level
- Master's degree
Licensed Clinical Social Worker
Headway —Virginia
- Up to $126 an hour
- Remote
- Private practice
- Licensed Clinical Social Worker
- Mid-level
Licensed Professional Counselor
Headway —Virginia
- Up to $126 an hour
- Remote
- Private practice
- Master's degree
- Senior level
Registered Nurse (RN) Float Pool
Twin County Regional Healthcare —Galax, VA
- $38.30 - $49.11 an hour
- Full-time
- Float pool
- RN License
- Hospital
- Disability insurance
- Health insurance
Quick Apply
Insurance Broker (Sales, Military, or Athletic Experience Preferred)
Empire Insurance Strategies —Virginia
- $50,000 - $250,000 a year
- Military
- Driver's License
- Driving
- Opportunities for advancement
- Flexible schedule
Quick Apply
9d
Insurance Broker (Former Athletes, sales, and military backgrounds preferred)
Limitless Financial —Virginia
- $60,000 - $200,000 a year
- Full-time
- Customer service
- Military
- Driver's License
- Opportunities for advancement
- Flexible schedule
Quick Apply
9d
Pharmacy Technician
Halsey Drug / Boone Drug —Sparta, NC
- Full-time
- Writing skills
- Assembly
- US work authorization
- Health savings account
- Health insurance
Quick Apply
MEDICAL ASSISTANT or LPN - Northern Family Medicine, Mount Airy
NORTHERN REGIONAL HOSPITAL —Mount Airy, NC
- Clean driving record
- Medical office experience
- BLS Certification
- AD&D insurance
- Disability insurance
10d
Nurse Practitioner or Physician Assistant
Curana Health —Galax, VA
- Full-time
- Nursing
- Clean driving record
- Patient monitoring
- Disability insurance
- Health insurance
Remote Orthopedic Physician (MD/DO) Outpatient Prior Authorizations (IC to FTE)
Virtix Health —United States
- $125 an hour
- 8 hour shift
- Remote
- Background check
- Medicine
- Doctoral degree
- Work from home
Quick Apply
Captive | Insurance Agent | Full-Time
Vemax Insurance Agency —United States
- $45,000 - $110,000 a year
- Full-time
- Remote
- Spanish
- English
- Mid-level
- Dental insurance
- Vision insurance
Quick Apply

More jobs to discover

Find similar jobs that you might be interested in.

Patient Representative - Orthopedics
Twin County Regional Healthcare —Galax, VA
Performs receptionist, registration, and clerical duties. Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and…
$14.41 - $17.79 an hour
Quick Apply
11d
Scribe - Carilion Orthopedic Surgery
Carilion Clinic —Blacksburg, VA
Reminds physician on the progress of lab, X-ray, or other patient evaluation data and transcribing the results into patient charts so that a patient's workup is…
$15.00 - $21.07 an hour

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Assessment Specialist OHC - Clark and Surrounding Counties
CareStar, Inc. —Springfield, OH
Processes specific Program Eligibility Assessment Tool (PEAT) or other tools and all related documents per agency and CareStar policy.
Quick Apply
Registered Nurse (RN)- Southwest Columbus
Aspire Home Healthcare of Ohio —Grove City, OH
✔ Valid driver’s license and reliable transportation. ✔ Active RN license in Ohio. ✅ Develop, implement, and evaluate individualized plans of care.
From $120,000 a year
9d

I want to receive the latest job alert for medicare insurance in galax, va

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

medicare insurance jobs near galax, va

Registered Nurse jobs in Galax, VA

Mental Health Technician jobs in Virginia

Insurance Broker jobs in Virginia

Medical Assistant jobs in Mount Airy, NC

Office Assistant jobs in Mount Airy, NC

Licensed Professional Counselor jobs in Virginia

Nurse Practitioner jobs in Galax, VA

Mental Health Therapist jobs in Virginia

Licensed Clinical Social Worker jobs in Virginia

Intake Specialist jobs in Appleton, WI

Clinical Documentation Improvement Specialist jobs in Houston, TX

Child Development Specialist jobs in Sacramento, CA

Intake Specialist jobs in Buncombe County, NC

Intake Specialist jobs in Pittsburgh, PA

Intake Coordinator jobs in Philadelphia, PA

Intake Specialist jobs in Kentwood, MI

Work From Home Nurse jobs in Columbus, OH

Registered Nurse jobs in Chicago, IL

Registered Nurse jobs in Olean, NY

Registered Nurse jobs in Maple Grove, MN

Provider Relations Representative, LTSS/BH

Humana -
Galax, VA

Apply Now

Job Details

Full-time
$59,300 - $80,900 a year
9 days ago

Benefits

Paid parental leave
Caregiver leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Parental leave
Vision insurance
Life insurance

Qualifications

Customer inquiry handling
Presentation preparation
Healthcare reimbursement methods

Full Job Description

Become a part of our caring community

The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in Humana's Healthy Horizons in Virginia Medicaid network. This role supports provider onboarding, training, education, and inquiry/issue support resolution. This role specifically supports long-term services and supports (LTSS) and home and community-based services (HCBS) providers and must be based in Virginia. The individual in this role should have critical thinking/problem solving skills, understanding of health plan operations, and strong interpersonal skills.

Serve as primary relationship manager with assigned LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons and promote network retention

Meet regularly, both in person and virtually, with assigned providers to conduct training and education, including, but not limited to, required annual trainings, periodic updates to and/or reviews of Humana policies and procedures, and Humana systems training and updates
Support newly assigned providers with onboarding, including hosting orientation session(s)
Respond to assigned provider inquiries and support prompt issue resolution, including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals)
Work with internal resources and systems (e.g., claims, reimbursement, provider enrollment) to provide Exceptional Experience in all provider interactions
Create provider trainings based on provider feedback, trends in claims or process changes
Educate provider on location and content of all provider facing materials (Orientation, Provider Manual, Newsletter, Program Updates, Etc.)
Convene regular meetings with providers, including organizing agendas, materials, meeting minutes, other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics
Educate on processes including claims submissions, recoupments, reconsiderations, authorizations, referrals, medical record management, Availity, Quality resources, and member resources
Communicate updates on Humana's policies and procedures and Cardinal Care programmatic updates
Coordinate regional provider townhalls and/or trainings
Attend Network Meetings/Conferences
Ensure compliance with all Virginia managed care contractual requirements for provider relations, such as timeframes for claims dispute resolution, provider complaints, provider inquiry response, etc

Use your skills to make an impact

Required Qualifications

Must reside in Virginia (SW region includes, Lee, Wise, Washington and Galax)
Bachelors degree OR 1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines

Preferred Qualifications

Master's Degree
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Comprehensive knowledge of Medicare policies, processes and procedures
Experience with Medicaid electronic visit verification (EVV)

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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

Scheduled Weekly Hours

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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.

Apply Now

Refine Your Search

medicare insurance jobs in galax, va

Provider Relations Representative, LTSS/BH

Patient Representative - Orthopedics

HEDIS Coordinator (Remote Option-NC)

OFFICE ASSISTANT - Northern Urgent Care

PATIENT INTAKE COMMUNICATION SPECIALIST

Licensed Mental Health Therapist

Licensed Mental Health Counselor

Licensed Clinical Social Worker

Licensed Professional Counselor

Registered Nurse (RN) Float Pool

Insurance Broker (Sales, Military, or Athletic Experience Preferred)

Insurance Broker (Former Athletes, sales, and military backgrounds preferred)

Pharmacy Technician

MEDICAL ASSISTANT or LPN - Northern Family Medicine, Mount Airy

Nurse Practitioner or Physician Assistant

Remote Orthopedic Physician (MD/DO) Outpatient Prior Authorizations (IC to FTE)

Captive | Insurance Agent | Full-Time

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for medicare insurance in galax, va

Explore jobs in more locations

Become a part of our caring community

Use your skills to make an impact

About us

Job Seeker Tools

Employer Tools

Browse

Stay Connected