Senior TRICARE Community Liaison

Mississippi, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Military Health SystemIndustries

Requirements

The Senior TRICARE Community Liaison must be knowledgeable, professional, and courteous, with a strong understanding of the military way of life and the impact of stress, trauma, and loss on service members and their families. This role requires self-direction, independent critical decision-making, and the ability to manage time and set priorities effectively. The position necessitates work during uncommon duty hours and travel for outreach activities.

Responsibilities

The Senior TRICARE Community Liaison will develop and sustain strong relationships with TRICARE beneficiaries, Medical Treatment Facility staff, Government staff, and healthcare providers in the East Region. They will ensure understanding of the TRICARE health plan and the Military Health System through clear communication. Responsibilities include assisting in network development and optimization, conducting market assessments to identify and address network gaps, researching and resolving complex TRICARE issues, and responding to inquiries regarding eligibility, enrollment, billing, claims, referrals, authorizations, network operations, and access to care. The liaison will also provide accurate explanations of TRICARE policies and procedures and may provide back-up coverage for the Health System Leader.

Skills

TRICARE

Community Outreach

Relationship Management

Healthcare Navigation

Military Culture

Communication

Problem-Solving

Critical Thinking

Network Development

Provider Relations

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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