Medicaid Provider Materials Lead

About the Role

Humana Healthy Horizons is seeking a Medicaid Provider Materials Lead to join our caring community and help us put health first. This role is responsible for leading a team to execute core provider educational materials for Humana’s Medicaid segment, aiming to drive a best-in-class provider experience.

Responsibilities

• Lead a team responsible for creating and updating provider educational materials during new contract implementations.
• Draft provider content from contract, policies, and processes across various business areas.
• Maintain up-to-date documentation based on state, market, or operational business changes.
• Collaborate across departments to execute provider educational resources that meet state contracted requirements and drive a best-in-class provider experience.
• Lead 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.
• Submit required documents to state agencies for review and approval.
• Regularly meet with Humana Healthy Horizons Medicaid markets to understand their provider training and education needs, ensuring an aligned segment strategy and approach.
• Create and update content for provider manuals, orientation, and annual training materials for new state contracts.
• Lead in the creation of new trainings as needed.
• Support Medicaid provider learning needs through collaboration across business segments for course content input.

Required Qualifications

• Must work hours within the Eastern Standard Time Zone.
• 5+ years of experience drafting provider content creation for resources, educational materials, or trainings.
• 3+ years of leadership experience working in a fast-paced environment with tight timelines.
• Bachelor’s degree and 3+ years of project management experience.
• 3+ years of Medicaid or contracting experience.
• Understanding of learning design principles and ideally proven application of those principles to create easy-to-read and captivating provider training and educational materials.
• Demonstrated experience building templates, standard documentation, policy, and procedures.
• Excellent written and oral communication, as well as interpersonal skills.
• Exceptional time management and ability to manage multiple priorities in a fast-paced environment.
• 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:

• 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.

Additional Information

• Travel: Up to 10%, possibly out of your home state.
• Workstyle: Remote, must work hours within the Eastern Standard Time Zone.