Overview

TriCare Community Liaison 1 Jobs in Texas at Humana

Title: TriCare Community Liaison 1

Company: Humana

Location: Texas

Description

Responsibilities

Position will be Work at Home, but candidate will need to live or be willing to relocate to the San Antonio TX area. This position will need to primarily be able to visit Randolph and possibly assist with Lackland and Brook Army Medical Center/Fort Sam to provide briefings.

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.

KEY ACCOUNTABILITIES

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.

Required Qualifications

Our Department of Defense contract requires U.S. Citizenship

Successfully receive interim approval for government security clearance (eQIP – Electronic Questionnaire for Investigation Processing)

This position will require the ability to travel and work on weekends/uncommon hours as needed to provide briefings (primarily at Randolph, possibly assist with Lackland and Brook Army Medical Center/Fort Sam)

Some travel out of san Antonio area but within the state of TX may be required

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

For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to: Provide proof of full vaccination, including booster or commit to testing protocols OR Provide proof of applicable exemption including any required supporting documentation. Medical, religious, state and remote-only work exemptions are available

Preferred Qualifications

Organizational skills necessary to effectively manage multiple activities

Experience with medical claims/health insurance

Project Management experience

Additional Information

Scheduled Weekly Hours

40

 

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