TRICARE Community Liaison
DescriptionAre 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 recently been awarded the T-5 East Region, the next generation of military health contracts.
This remote position requires candidates to live within a 1 hour commute of Albany, NY or Saratoga Springs, NY area.
The TRICARE Community Liaison (TCL) is a customer-facing Humana Military associate who is knowledgeable, professional and courteous. This role interacts with TRICARE beneficiaries; Medical Treatment Facility (MTF) staff; and civilian healthcare providers and facilities in person and by other means, such as by telephone, e-mail, and chat. The primary focus of the TCL is to develop and sustain strong, collaborative relationships with all TRICARE customers – Government, beneficiaries, and providers. 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 Manager/Consultant in managing the local TRICARE network in designated Prime Service Areas (PSAs) and Non-Prime Service Areas (NPSAs), including participating in network development and optimization strategies. This position may require travel to conduct outreach activities.
Provide accurate explanation of TRICARE health plan policies and procedures during customer support activities, ensuring compliance with all contract standards.
Respond appropriately and timely to inquiries regarding eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics.
Research and resolve complex TRICARE problems/issues elevated by a Government agent, beneficiary, or provider within required timelines.
Assist in developing and sustaining a high-performing network in designated PSAs/NSPAs which meets TRICARE and Humana Government Business requirements and optimization strategies.
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.
Participate in activities that promote well-being and professional growth of self and others.
Our Department of Defense contract requires U.S. Citizenship
Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
Willingness to travel and work uncommon hours - involves frequent overnight travel within the New England area, NJ, and NY and weekend hours.
Need to reside within a 1 hour commute of Albany or Saratoga Springs, NY 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 activities
Experience in analyzing information, researching problems, and determining and implementing solutions
Experience in healthcare provider relations
Knowledge of the TRICARE program
Scheduled Weekly Hours40
Pay 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$47,700 - $65,600 per year
This 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.