TRICARE Community Liaison

Become a part of our caring community and help us put health firstAre you looking to join a team where you can be a part of our important mission of supporting the TRICARE healthcare program for our nation's military? Humana Government Business is a top 10 Department of Defense contractor, with a long history in the TRICARE business and has been awarded the T-5 East Region, the next generation of military health contracts.The TRICARE Community Liaison (TCL) is a customer-facing Humana Military associate who is knowledgeable, professional and courteous. This role interacts in person and by other means, such as by telephone, e-mail, and chat with TRICARE beneficiaries, Medical Treatment Facility (MTF) and other Government staff, including senior military leaders, and civilian healthcare providers and facilities. The primary focus of the TCL is to develop and sustain strong, collaborative relationships with all TRICARE customers in the East Region - Government, beneficiaries, and providers. The TCL must be cognizant of the military way of life during all interactions, including the impact of stress, trauma, and loss on active, reserve component and retired service members and their families that result from military operations. Assigned to cover specific Health System Areas comprised of Prime Service Areas (PSAs) and Non-Prime Service Areas (NPSAs), the associate's area of responsibility can average more than 62,000 beneficiaries, 8,000 network providers, dozens of National Guard/Reserve units, and three to four MTFs within a geographic territory that may cover over 43,000 square miles. Through clear and concise communication, the TCL is responsible for ensuring MTF, beneficiary, and provider understanding of the TRICARE health plan and how to navigate the Military Health System. The TCL also supports the Health System Operations Leader in local TRICARE network operations, including participating in network development and optimization strategies which generate revenue for the company and increase healthcare trend and discount incentives paid by the Government.KEY ACCOUNTABILITIES- Provide accurate explanation of TRICARE health plan policies and procedures during on-site and electronic beneficiary, provider, and Government outreach activities, ensuring compliance with all customer support performance standards for the dual purposes of maximizing TRICARE customer satisfaction and the incentives paid by the Government, and of sustaining Humana Military's competitive advantage for future contracts.- Respond in precise, comprehensive and timely manner 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. Implement self-directed activities to analyze, coordinate, process, and complete action to correct multifaceted problems relating to eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics.- Assist in developing and sustaining a high-performing network in designated PSAs/NSPAs which meets TRICARE and Humana Government Business requirements and optimization strategies. Contribute in achieving the network discount goal that results in annual financial incentives awarded by the Government. Conduct regular and ad hoc market laydown assessments to determine the capability and capacity of TRICARE providers, identifying and implementing action to address any gaps in the network. Participate in value-based care pilots through effective communication, consultation and support of selected providers.- Accomplish all administrative tasks as assigned, including documenting interactions, processing transactions, and submitting required reports.- Respond to and assist in contingency operations in support of the MTF and network as needed. Conduct urgent market laydown assessments to determine the capability and capacity of TRICARE providers, identifying and implementing action to accommodate changes in MTF services.Use your skills to make an impactRequired Qualifications- Our Department of Defense contract requires U.S. Citizenship- Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)- Must be willing to work on site at Tyndall AFB in Panama City, FL area.- Position will require living in the Panama City, FL area, as it will be required to work in the office at Tyndall AFB several days a week, and the other days from home.- Willingness to travel and work uncommon hours - involves some travel to other clinics and locations in the area to provide briefings.- One or two years' experience in customer relations, public contact position, and/or TRICARE, including presentations to groups- Experience in handling high volume customer contacts in a courteous and professional manner- Excellent oral and written communication skills- Exceptional public-speaking ability- Comprehensive knowledge of Microsoft Office Suite- Superior organizational skills necessary to effectively manage multiple activitiesPreferred Qualifications- Experience in analyzing information, researching problems, and determining and implementing solutions- Experience in healthcare provider relations- Knowledge of the TRICARE programWork 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- 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.- Humana 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#LI-JB2Scheduled Weekly Hours40Pay RangeThe 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.$47,700 - $65,600 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of BenefitsHumana, 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.About UsHumana 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 EmployerIt 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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.