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Medicaid Provider Materials Lead

hace 4 semanas

Rosario, Santa Fe, Argentina Humana A tiempo completo

Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City and state must be separated by a comma followed by a space (e.g., Houston, TX )

Humana Medicaid Provider Materials Lead in Santa Fe, New Mexico

Become a part of our caring community and help us put health first

Humana Healthy Horizons is seeking a Medicaid Provider Materials Lead who is responsible for leading a team to execute core provider educational materials for Humana's Medicaid segment to drive best in class provider experience. This role will create and update content for provider manuals, orientation, and annual training materials for new state contracts.

The Medicaid Provider Materials Lead will lead a team that tracks all provider materials for state submissions and send necessary documents to the state for implementations. This individual will also lead in the creation of new trainings as needed and support Medicaid provider learning needs through collaboration across business segments for course content input. This leader will demand strong content creation skills to create provider materials, interpersonal skills to work across business segments, and must be highly organized.

Key Responsibilities
  1. Leads a team that is responsible for creating provider educational materials during new contract implementations.
  2. Drafting provider content from contract, policies, and processes across various business areas.
  3. Maintains up to date documentation based off state, market, or operational business changes.
  4. Collaborates across departments to execute provider educational resources to meet state contracted requirements to drive best in class provider experience.
  5. Leads annual reviews of provider manuals, orientation and annual training materials, including materials specific to behavioral health and long-term care providers to ensure updates meet required timelines.
  6. Maintains provider material list for implementation to track materials throughout the review process.
  7. Submits required documents to state agencies for review and approval.
  8. Regularly meet with Humana Healthy Horizons Medicaid markets to understand their provider training and education needs to ensure aligned segment strategy and approach.

Use your skills to make an impact

Required Qualifications
  1. Must work hours within the Eastern Standard Time Zone.
  2. 5+ years of experience drafting provider content creation for resources, educational material, or trainings.
  3. 3+ years of leadership experience working in a fast-paced environment with tight timelines.
  4. Bachelor's degree and 3+ years of project management experience.
  5. 3+ years of Medicaid or contracting experience.
  6. Understanding of learning design principles and ideally proven application of those principles to create easy-to-read and captivating provider training and educational materials.
  7. Demonstrated experience building templates, standard documentation, policy, and procedures.
  8. Excellent written and oral communication, as well as interpersonal skills.
  9. Exceptional time management and ability to manage multiple priorities in a fast-paced environment.
  10. Experience operating in a matrixed environment and coordinating across various departments.
Preferred Qualifications
  • Experience with Medicaid policies and/or Medicaid health plan operations, such as provider relations, claims submission and payment, utilization management processes, behavioral health processes, and dispute resolution.
Work at Home Requirements

To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

  1. 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.
  2. Satellite, cellular and microwave connection can be used only if approved by leadership.
  3. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  4. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  5. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Additional Information
  1. Travel: Up to 10%, possibly out of your home state.
  2. Workstyle: Remote, must work hours within the eastern time zone.
  3. Direct Reports: Up to 5 associates.
  4. Core Workdays & Hours: Typically, 8-5 pm Monday – Friday Eastern Standard Time (EST).
  5. Benefits: Benefits are effective on day 1. Full time Associates enjoy competitive pay and a comprehensive benefits package that includes 401k, Medical, Dental, Vision and a variety of supplemental insurances, tuition assistance and much more.
Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

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.

$104,000 - $143,000 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 04-29-2025

About us

Humana Inc. (NYSE: HUM) 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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our accessibility resources.

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