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Freight Conductor - Marysville, OH
CSX
Marysville, OH
Depending in the business need, you may be placed in a pipeline during the hiring process. If you are selected for the position, more information about the pipeline possibility will be…
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Clinical Team Supervisor/ Madison, WI (On-Site)
FTCRUMAD Fortrea Clinical Research Unit Inc.
United States
…dignity of study participants. This position reports to the Manager, Clinical…
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Revenue Accounting Manager
Iterable
Remote, United States
- $112,000 to $151,000 USD / year
As the Revenue Accounting Manager, you will play a critical role in overseeing the company's revenue recognition and cash conversion processes. As a key individual contributor, you will be…
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Service Lot Porter - BMW of Chula Vista
Sunroad Automotive
Chula Vista, CA
…assisting customers, and supporting the service department's daily operations. This role ensures that vehicles are properly parked, serviced, and ready for customer pickup, contributing to…
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Senior Product Manager
Millennium Healthcare Management Serv LLC
FL
The Senior Product Manager provides delivery direction and assigns priorities within the established roadmap. The Product Operations Lead independently leads defined workstreams,…
Added 1 min ago
Regional Director of Operations
Xtreme Racing Pigeon Forge
Remote, United States
The Regional Director of Operations (RDO) of Five Star Parks & Attractions is responsible for the day-to-day operational performance of a group of parks within an assigned region. Reporting…
Added 1 min ago
Regional Director of Operations
Fun Land
Remote, United States
The Regional Director of Operations (RDO) of Five Star Parks & Attractions is responsible for the day-to-day operational performance of a group of parks within an assigned region. Reporting…
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Ice Cream Store Manager
Sundae Artisan Ice Cream
Vail, CO
- $60,000 to $65,000 USD / year
Collaborate closely with the Production Manager to ensure cohesive retail and production operations, supporting consistent product quality and operational success.
Added 1 min ago
EHS Functional Manager
Listings
HOUSTON, TX
The EHS Functional Manager provides functional leadership, technical expertise, and strategic support for Environmental, Health, and Safety programs across assigned locations or business…
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Manager, Governance and Enablement
HP
Austin, TX · Vancouver, WA
- $147,050 to $230,850 USD / year
Governance and Process Improvement: Establish and improve processes, standards, and workflows that support consistent design practices, effective collaboration, and scalable operations.
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Project Manager, Permitting [Virginia]
Pulley
United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 1 min ago
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Lead Program Administrator (Bookkeeping & Operations), Language Services
International Institute of New England
Manchester, NH
- $28.79 USD / hour
Lead Program Administrator (Bookkeeping & Operations), Language Services - Manchester, NH
Added 1 min ago
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Project Manager, Permitting [Florida]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 1 min ago
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Project Manager, Permitting [Massachusetts]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
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Project Manager, Permitting [Texas]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 1 min ago
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Project Manager, Permitting [South Carolina]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 1 min ago
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Project Manager, Permitting [North Carolina]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 1 min ago
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Project Manager, Permitting [Georgia]
Pulley
Remote, United States
- $120,000 to $130,000 USD / year
Project Managers are essential to success. As a Project Manager, you are the key link between clients and the intricate permitting landscape. Your work ensures that projects progress…
Added 2 mins ago
Consultant
Reef Point Group
Falls Church, VA
ReefPoint Group is seeking a proactive, analytical Program Manager Analyst (Contractor) to support the implementation, coordination, and sustainment of the Navy Medicine Lessons Learned…
Added 2 mins ago
Plant Manager - Utica, NY
Indium Corporation
Utica, NY
JOB SUMMARY: The Plant Manager is responsible for translating and implementing operating strategies to ensure that all plant operations meet or exceed organizational goals and objectives.
Added 2 mins ago
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IT Risk Sr. Analyst - First Line Operational Risk
Corient Services LLC
United States
- $90,000 to $112,000 USD / year
Partnering with Compliance, Finance, Operations and IT to support strategic priorities, risk mitigation and control execution
Added 2 mins ago
PR
Marketing Specialist, Marketing Ops & Trafficking
Plymouth Rock Assurance Corporation
Woodbridge, NJ
- $70,000 to $90,000 USD / year
The Marketing Specialist, Marketing Operations & Trafficking ensures that paid media campaigns are set up, trafficked, tracked, and reconciled accurately and on time. This role is part of…
Added 2 mins ago
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Store Lead - Southland Mall - Part time
The Childrens Place, Inc.
United States
- Part-time
The Store Lead will be responsible for supporting the Store Leadership Team by completing cash-wrap operations, opening and closing procedures, and acting as Leader on Duty (LOD). The Store…
Added 2 mins ago
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Store Lead - Gilroy Premium Outlets - Part Time
The Childrens Place, Inc.
United States
- Part-time
The Store Lead will be responsible for supporting the Store Leadership Team by completing cash-wrap operations, opening and closing procedures, and acting as Leader on Duty (LOD). The Store…
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Director of Rooms
Career Site Brand
Kissimmee, FL
The Director of Rooms Operations provides strategic and operational leadership for all rooms-related functions, ensuring exceptional owner and guest experiences while maximizing operational…

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.

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