Senior TRICARE Community Liaison

4 weeks ago


Montgomery, Alabama, United States Humana Full time
Job Summary

We are seeking a highly skilled and experienced Senior TRICARE Community Liaison to join our team at Humana. As a Senior TRICARE Community Liaison, you will be responsible for developing and sustaining strong, collaborative relationships with all TRICARE customers in the East Region - Government, beneficiaries, and providers.

Key Responsibilities:

  • Provide accurate explanations of TRICARE health plan policies and procedures during on-site and electronic beneficiary, provider, and Government outreach activities.
  • Respond to beneficiary, provider, and Government inquiries regarding eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics.
  • Implement, track, and complete self-managed tasks to process and correct uncomplicated general eligibility, enrollment, billing, claims, referral/authorization, and network difficulties experienced by TRICARE customers.
  • Research and resolve difficult, complex TRICARE problems/issues elevated by a Government agent, beneficiary, or provider within required timelines.
  • Assist in developing and sustaining a high-performing network in designated PSAs/NSPAs which meets TRICARE and Humana Government Business requirements and optimization strategies.

Requirements:

  • Experience in customer relationship management, demonstrating courteous, professional interactions.
  • Experience in analyzing information, researching problems, and determining and implementing solutions.
  • Experience in healthcare provider relations.
  • Exceptional public-speaking ability.
  • Strong computer skills with business software.
  • Superior organizational skills necessary to effectively manage multiple activities.

Preferred Qualifications:

  • Three to four years' experience in TRICARE, including presentations to groups.
  • Knowledge of healthcare provider contract negotiations.

About Humana:

Humana is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services and 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.



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