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Bilingual(Spanish and English)Provider Relations Specialist - Miami Dade and Monroe County, FL
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Miami, FL Miami, Florida |
About this job
Role: Bilingual(Spanish and English) Provider Relations Specialist
Assignment: Humana American Eldercare
Location: Miami Dade and Monroe County, FL
We're looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our providers, consumers, employers, agents and others we work with. At Humana, Perfect Service means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our providers, members, employers, and colleagues. We're looking for people who improve their own well-being by looking out for the best interests of others.
Assignment Capsule
Be part of the Provider Contracting world at Humana where you will help maintain a competitive network for our members.
Humana American Eldercare is seeking a Bilingual Provider Relations Specialist who will establish and maintain a network of licensed and compliant providers that meet the skilled and unskilled service needs of the member population in Miami Dade and Monroe counties. Regularly communicates with the Care Management team on Provider Relations updates and issues.
Job Functions
Evaluates member service needs reports to ensure that there are sufficient providers contracted to meet member care needs.
Negotiates and maintains contractual relationships with vendors in areas of service needs.
Updates and maintains on network tracking system the current status of pending and renewing vendor applications.
Schedules and organizes outreach presentations and serves as educator/liaison with providers to ensure providers are current on HAEC programs, policies & procedures, billing practices, accessibility standards and contracted service requirements.
Responds to corporate office requests to obtain updated status on pending contracts and outstanding documentation and/or compliance issues.
Attends trade organization events, conferences and business networking meetings on a regular basis to market HAEC products and programs.
Consistently meets established productivity
Key Competencies
Interpersonal Effectiveness : Understands oneself, effectively manages emotions, listens and communicates with respect, and builds trusting relationships.
Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
Accountability: Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.
Role Essentials
High School Diploma or equivalent.
This role is 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.
Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work
Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite)
One to three years related experience.
Must be bilingual (Spanish and English)
Must possess strong communication skills, both verbal and written.
Excellent interpersonal s. ls.
Knowledge of all Microsoft Office programs.
This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Role Desirables
Bachelor's Degree.
Three years healthcare industry experience working in Provider Relations.
Knowledge of Long Term Care Manage Care Plan.
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Assignment: Humana American Eldercare
Location: Miami Dade and Monroe County, FL
We're looking for associates who are dedicated to service and believe in following the Golden Rule of treating others the way you want to be treated. Humana was founded on this premise, and this value is reflected in our expectations for providing perfect service to our providers, consumers, employers, agents and others we work with. At Humana, Perfect Service means getting the basics done right, delivering value and quality, and providing everyone with personalized attention and guidance. We want to engage with our members through every step of their journey to lifelong well-being. This includes meaningful direct consumer interaction and developing positive relationships with healthcare providers. Humana associates provide Perfect Service every day to our providers, members, employers, and colleagues. We're looking for people who improve their own well-being by looking out for the best interests of others.
Assignment Capsule
Be part of the Provider Contracting world at Humana where you will help maintain a competitive network for our members.
Humana American Eldercare is seeking a Bilingual Provider Relations Specialist who will establish and maintain a network of licensed and compliant providers that meet the skilled and unskilled service needs of the member population in Miami Dade and Monroe counties. Regularly communicates with the Care Management team on Provider Relations updates and issues.
Job Functions
Evaluates member service needs reports to ensure that there are sufficient providers contracted to meet member care needs.
Negotiates and maintains contractual relationships with vendors in areas of service needs.
Updates and maintains on network tracking system the current status of pending and renewing vendor applications.
Schedules and organizes outreach presentations and serves as educator/liaison with providers to ensure providers are current on HAEC programs, policies & procedures, billing practices, accessibility standards and contracted service requirements.
Responds to corporate office requests to obtain updated status on pending contracts and outstanding documentation and/or compliance issues.
Attends trade organization events, conferences and business networking meetings on a regular basis to market HAEC products and programs.
Consistently meets established productivity
Key Competencies
Interpersonal Effectiveness : Understands oneself, effectively manages emotions, listens and communicates with respect, and builds trusting relationships.
Builds Trust: Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
Accountability: Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.
Role Essentials
High School Diploma or equivalent.
This role is 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.
Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work
Must have accessibility to high speed DSL or Cable modem for a home office (No Satellite)
One to three years related experience.
Must be bilingual (Spanish and English)
Must possess strong communication skills, both verbal and written.
Excellent interpersonal s. ls.
Knowledge of all Microsoft Office programs.
This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Role Desirables
Bachelor's Degree.
Three years healthcare industry experience working in Provider Relations.
Knowledge of Long Term Care Manage Care Plan.
Additional Information
Humana is an organization with careers that change lives---including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you're ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
Interview Format
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.