Lead, Medicaid Provider Services Implementation
About the position
The Lead, Medicaid Provider Services Implementation at Humana is responsible for overseeing the implementation of provider services functions in new Medicaid markets. This role involves creating and executing processes and solutions for non-standard contract requirements, ensuring compliance with contractual obligations, and resolving complex operational challenges. The position requires collaboration across departments to deliver best-in-class provider experiences and support the rollout of new market initiatives.
Responsibilities
Responsible for effective and timely implementation of provider services business functions in new Medicaid markets.
,
Develop tailored provider education materials and communications strategy.
,
Create and execute provider onboarding plans.
,
Partner cross-functionally to ensure compliance with contractual requirements during new market go-live.
,
Assist in hiring new market Provider Services department leadership and mentor them post-go-live.
,
Facilitate workgroup calls and meetings for provider services action plan development.
,
Create and manage project plans for effective market rollouts, prioritizing work and escalating risks as needed.
,
Serve as a subject matter expert on non-standard contractual requirements and local needs for Medicaid markets.
,
Engage in multiple new market implementations simultaneously, understanding contract provisions to guide team members.
,
Improve standard operating procedures to drive efficiencies in new market implementations.
,
Cultivate strong working relationships with operational and shared services partners.
Requirements
Bachelor's Degree.
,
3+ years of Medicaid experience.
,
5+ years of experience with health plan operations, provider services, and provider relations.
,
Proven expertise in driving operational efficiencies and managing timelines and processes.
,
Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment.
Nice-to-haves
Benefits
Apply Now
The Lead, Medicaid Provider Services Implementation at Humana is responsible for overseeing the implementation of provider services functions in new Medicaid markets. This role involves creating and executing processes and solutions for non-standard contract requirements, ensuring compliance with contractual obligations, and resolving complex operational challenges. The position requires collaboration across departments to deliver best-in-class provider experiences and support the rollout of new market initiatives.
Responsibilities
Responsible for effective and timely implementation of provider services business functions in new Medicaid markets.
,
Develop tailored provider education materials and communications strategy.
,
Create and execute provider onboarding plans.
,
Partner cross-functionally to ensure compliance with contractual requirements during new market go-live.
,
Assist in hiring new market Provider Services department leadership and mentor them post-go-live.
,
Facilitate workgroup calls and meetings for provider services action plan development.
,
Create and manage project plans for effective market rollouts, prioritizing work and escalating risks as needed.
,
Serve as a subject matter expert on non-standard contractual requirements and local needs for Medicaid markets.
,
Engage in multiple new market implementations simultaneously, understanding contract provisions to guide team members.
,
Improve standard operating procedures to drive efficiencies in new market implementations.
,
Cultivate strong working relationships with operational and shared services partners.
Requirements
Bachelor's Degree.
,
3+ years of Medicaid experience.
,
5+ years of experience with health plan operations, provider services, and provider relations.
,
Proven expertise in driving operational efficiencies and managing timelines and processes.
,
Exceptional time management skills and ability to manage multiple priorities in a fast-paced environment.
Nice-to-haves
Benefits
Apply Now