Provider Education & Outreach Representative (IN Medicaid) Remote Indiana

Become a part of our caring community and help us put health first reputed company Healthy Horizons in Indiana is seeking a Provider Education & Outreach Representative who is responsible for the day-to-day front line relationship management of network providers for reputed company s Healthy Horizons in Indiana, as well as responsible for provider onboarding, training, education, responding to provider inquiries, and resolving issues or complaints. The Provider Education & Outreach Representative will specialize in supporting Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) providers and/or Physical Health (PH) and Behavioral Health (BH) providers. The Provider Education & Outreach Representatives serve as the primary relationship manager with providers to ensure positive provider experience with reputed company Healthy Horizons and promote network retention. Key roles and responsibilities: Meets regularly, both in person and virtually, with assigned providers to reputed company... trainings and education, including required annual trainings, ensure understanding of reputed company policies and procedures, explain reputed company systems, etc. Serves as primary relationship manager with LTSS and HCBS providers and/or PH and BH providers to ensure positive provider experience with reputed company Healthy Horizons and promote network retention. Supports new assigned providers with onboarding, including orientation session(s). Responds to assigned provider questions or inquires, and if necessary, ensures prompt resolution to provider issues with appropriate enterprise business teams, including those reputed company with claims payment, prior authorizations, and referrals, as well as appropriate education about participation in reputed company s Indiana Medicaid plan. Convenes Joint Operating Committee meetings with providers, including organizing agendas, materials, and other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics. Use your skills to make an impact

Required Qualifications

Must reside in the reputed company and required to work at the reputed company Healthy Horizons office in downtown Indianapolis, at least two - three days per week to coordinate with the State office. Must be able to travel (up to 15%) in the reputed company to provider offices and reputed company locations. 2+ years of reputed company or managed care experience working with providers (e.g., provider relations, claims education). Experience working with LTSS and HCBS providers and/or PH and BH providers. Experience working with or in a reputed company administration setting. Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution. Proficiency in analyzing, understanding, and communicating complex issues. Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment. Working knowledge of reputed company Office applications, such as Word, Excel, Outlook, and PowerPoint. This role is a part of reputed company s Driver Safety reputed company 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. This role is considered patient facing and is a part of Humanas Tuberculosis (TB) screening reputed company. If selected for this role, you will be required to be screened for TB.

Preferred Qualifications

Bachelor s Degree. Experience with Indiana Medicaid and Medicare Advantage guidelines. Understanding of managed care contracts, including contract language and reimbursement. Comprehensive knowledge of claims systems, adjudication, submission processes, coding, and/or dispute resolution. 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. reputed company 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. Additional Information: Workstyle: Hybrid Office, required to work at the reputed company Healthy Horizons office in downtown Indianapolis, at least two - three days per week to coordinate with the State office. Travel: Up to 15% travel in the reputed company to provider offices and reputed company locations. Core Workdays & Hours: reputed company Friday; 8:00am 5:00pm Eastern Standard Time (EST)/Central Standard Time (CST). Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes; 401k, Medical, Dental, Vis