Remote jobs in the United States

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Added 38 mins ago
Senior Partner Program Manager
Jobgether
Remote, United States
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Partner Program Manager based in the United States.
Added 38 mins ago
J
Principal Product Manager, Protection Programs
Jobgether
Remote, United States
- $170,000 to $205,000 USD / year
The Principal Product Manager will own the strategy, development, and performance of a portfolio of protection programs designed to reduce financial risk and build customer confidence…
Added 38 mins ago
J
Business SOX Compliance Manager
Jobgether
Remote, United States
- $83,597 to $126,450 USD / year
The Business SOX Compliance Manager will lead business process compliance initiatives and strengthen the global internal control environment to support accurate and reliable financial…
Added 1 hour ago
VH
Physician - Diagnostic Radiologist (REMOTE & SIGN ON BONUS)
Veterans Health Administration
Remote, United States
- $350,000 to $400,000 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and…
Added 1 hour ago
VH
Medical Records Technician (Coder Outpatient )
Veterans Health Administration
Remote, United States
- $36,409 to $72,644 USD / year
…needed to ensure proper patient classification in the VERA…
Added 1 hour ago
J
IRT Project Manager- FSP
Jobgether
Remote, United States
- $110,000 to $125,000 USD / year
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an IRT Project Manager – FSP based in the United States.
Added 1 hour ago
Coordinator – TempAlert Repairs & Maintenance
CVS Health
Remote, United States
…with onsite colleagues via outbound phone calls to provide remote troubleshooting steps as indicated by the established workflow. You will be supported by robust standard operating…
Added 1 hour ago
J
Staffing Account Manager
Jobgether
Remote, United States
- $60,000 to $88,000 USD / year
The Staffing Account Manager will coordinate temporary clinician staffing across hospital practices, ensuring coverage needs are met while maintaining strong relationships with clinicians…
Added 1 hour ago
J
Senior Manager, Customer Marketing
Jobgether
Remote, United States
- $200,000 to $230,000 USD / year
…applications and next steps. Our partner is looking for a Senior Manager, Customer Marketing based in the United…
Added 1 hour ago
J
Senior Manager, Clinical Operations - Operational Excellence
Jobgether
Remote, United States
- $120,000 to $165,000 USD / year
…applications and next steps. Our partner is looking for a Senior Manager, Clinical Operations – Operational Excellence based in the United…
Added 1 hour ago
J
RCM Vendor Operations Manager
Jobgether
Remote, United States
- $60,000 to $70,000 USD / year
The RCM Vendor Operations Manager will oversee the relationships, productivity, and performance of third-party billing vendors supporting healthcare revenue cycle management operations.…
Added 1 hour ago
PH
Registered Nurse - Clinical Case Consultant - ECM
Pacific Health Group
Remote, United States
- $85,000 to $95,000 USD / year
…Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving…
Added 1 hour ago
PH
Associate Therapist/ECM Consultant - Full Time
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
- Full-time
Must hold a current California license as one of the following:
Added 1 hour ago
PH
Associate Therapist/ECM Consultant
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
Must hold a current California license as one of the following:
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing) - San Benito County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing) - San Benito County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing) - San Benito County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Community Supports Lead Care Coordinator (Housing)- Monterey County
Pacific Health Group
Remote, United States
- $30 to $35 USD / hour
This position is an individual contributor, not a People Manager.
Added 1 hour ago
PH
Registered Nurse - Clinical Case Consultant - ECM
Pacific Health Group
Remote, United States
- $85,000 to $95,000 USD / year
…Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving…
Added 1 hour ago
PH
Registered Nurse - Clinical Case Consultant - ECM
Pacific Health Group
Remote, United States
- $85,000 to $95,000 USD / year
…Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving…

Closed listing

Humana

Provider Relations Representative

Remote, United States

$59,300 - $80,900 per year

This opening has closed.

The original listing is kept below for reference.

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About employer

Job details

Pay: $59,300 - $80,900 per year
Working hours: 40 hours per week
Posting language: English
Posted: Nov 2, 2026

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Original job description

Archived listing. The details below describe a past opening.

Become a part of our caring community

The Provider Relations Representative is responsible for day-to-day, front-line relationship management for network providers in Humana. This role supports provider onboarding, training, education, and inquiry/issue support and resolution. The individual in this role should have critical thinking/problem solving skills, an understanding of health plan operations, and strong interpersonal skills. This role develops and grows positive, long-term relationships with BH providers.

Serve as primary relationship manager with assigned providers to ensure positive provider experience with Humana’s Dual Fully Integrated and Healthy Horizon plan of Illinois and promote network retention · Meet regularly, both in-person and virtually, with assigned providers to conduct training and education, including, but not limited to, required annual trainings, periodic updates to and/or reviews of Humana policies and procedures, and Humana systems training and updates · Support newly assigned providers with onboarding, including hosting orientation session(s) · Respond to assigned provider inquiries and support prompt issue resolution, including, where necessary, collaboration with appropriate enterprise business teams (ex., claims payment, prior authorizations & referrals) · Work with internal resources and systems (e.g., claims, reimbursement, provider enrollment) to provide the Exceptional Experience in all provider interactions · Create provider trainings based on provider feedback, trends in claims or process changes · Educate provider on location and content of all provider facing materials (Orientation, Provider Manual, Newsletter, Program Updates, Etc.) · Convene regular meetings with providers, including organizing agendas, materials, meeting minutes, other team members (clinical, provider engagement), to discuss key operational, clinical, and quality related topics · Educate on processes including claims submissions, recoupments, reconsiderations, authorizations, referrals, medical record management, Availity, Quality resources, and member resources · Communicate updates on Humana’s policies and procedures and Cardinal Care programmatic updates · Coordinate periodic regional provider townhalls and/or trainings · Attend Network Meetings/Conferences · Ensure compliance with all Virginia managed care contractual requirements for provider relations, such as timeframes for claims dispute resolution, provider complaints, provider inquiry response, etc.

Use your skills to make an impact

Required Qualifications

Candidate must reside within Cook County in Illinois.
2 or more years of health care or managed care experience working with providers (e.g., provider relations, claims education)
Experience with Illinois Medicaid
Experience working with Behavioral Health providers and Community Mental Health Centers.
Experience in provider operations, building strong relationships with provider organizations, financial/contracting arrangements, and/or regulatory requirements
Exceptional relationship management and interpersonal skills
Thorough understanding of managed care contracts, including contract language and reimbursement
Position is field based in Illinois and requires frequent travels to provider and Humana locations

Preferred Qualifications

Understanding of claims systems, adjudication, submission processes, coding, and/or dispute resolution
Understanding of service coordination, prior authorizations, and other health plan processes
Understanding of value-based payment programs

Additional Information This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.

This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40 Pay Range The 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.

$59,300 - $80,900 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

Equal Opportunity Employer

It 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.

About employer

More about this job

Skills

Critical thinking
Problem solving
Interpersonal skills
Regulatory compliance
Mental health

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Work requirements

Remote jobs in the United States