Humana Senior Concierge Broker Professional in San Antonio, Texas
The Senior Concierge Broker Professional investigates, analyzes, and develops creative solutions to client specific problems related to systems, claims, networks, providers, eligibility, billing, collections, etc. through active cross-functional team participation The Senior Concierge Broker Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior Concierge Broker Professional will be responsible for supporting business consulting by providing data, information, and critical analysis for optimal decision making and execution in regard to all aspects and functions of Government Services. This includes identifying data sources, preparing and analyzing data, developing reports and charts to display information, and identifying options or making recommendations accordingly. Interfaces with Humana Military business segments and the Defense Health Agency (DHA) TRICARE Health Plan (THP) on data operations, use of the Government Portal, contingency operations, and other programs.
Function as data consultant and liaison between TRO-East and Humana Military, including processing operational data requests from Humana Military business leaders, enhanced MultiService Markets (eMSMs) and Military Treatment Facilities (MTFs).
Operate the regional help desk and resolve first tier user inquiries related to the Government Portal and second tier inquiries regarding the Provider Portal.
Develop and deliver training to Government users of the Government Portal and the TRICARE Report Gallery.
Develop and maintain statistical reports and control charts of Humana Military management systems and TRICARE contract standards and metrics in accordance with established procedures.
Plan, conduct, and report contingency exercises and operations in compliance with contract requirements.
Maintain alignment tables required to manage locality reports and analysis of designated geographic areas of the TRICARE region. Create territorial and population density maps using specified mapping application.
Our Department of Defense contract requires U.S. citizenship for this position.
This role description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this role description. The individual(s) may be called upon and required to follow other instructions or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives.
BS/BA in Business, Health Care Administration or a medical discipline or equivalent education and/or experience
Minimum of three years of experience in a managed care or health care environment
Keen verbal and written communication skills
Proven ability to establish and maintain strong professional, collaborative relationships
Masterful problem-solving skills
Skilled in quantitative data analysis tools, techniques, and reporting (i.e. Excel, Access, SAS, SQL, Tableau, Microsoft Power Business Intelligence)
Proficient in use of Microsoft Office products
Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
U.S. Citizenship is required by our Department of Defense contract
Graduate degree in Business, Health Care, Health Care Administration, or other related field
Experience with TRICARE contracts and/or the military health care delivery system
Certification by a professional organization
Extensive knowledge of TRICARE policies and programs
Excellent negotiation skills
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire Text to enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive a correspondence inviting you to participate in a Modern Hire Text interview. In this interview, you review a set of interview questions over your phone and you will provide text responses to each question. You should anticipate this interview to take about 15 to 20 minutes. Your text message interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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