[Remote] TRICARE Community Liaison at Humana

Florida, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Knowledgeable, professional, and courteous demeanor
Ability to interact with TRICARE beneficiaries, Medical Treatment Facility (MTF) and other Government staff, including senior military leaders, and civilian healthcare providers and facilities
Cognizant of the military way of life, including the impact of stress, trauma, and loss on service members and their families
Ability to communicate clearly and concisely
Ability to implement, track, and complete self-managed tasks
Ability to research and resolve complex TRICARE problems/issues
Ability to analyze, coordinate, process, and complete action to correct multifaceted problems
Ability to assist in developing and sustaining a high-performing network
Ability to contribute to achieving network discount goals
Ability to conduct market laydown assessments

Responsibilities

Develop and sustain strong, collaborative relationships with all TRICARE customers in the East Region
Provide accurate explanation of TRICARE health plan policies and procedures
Respond to beneficiary, provider, and Government inquiries regarding TRICARE topics
Process and correct general eligibility, enrollment, billing, claims, referral/ authorization, and network difficulties
Resolve difficult, complex TRICARE problems/issues
Assist in developing and sustaining a high-performing network
Contribute to achieving network discount goals
Conduct market laydown assessments

Skills

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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