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Humana Senior Concierge Broker Professional in San Antonio, Texas

Description

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.

Responsibilities

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.

KEY ACCOUNTABILITIES

  • 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.

Required Qualifications

  • 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

Preferred Qualifications

  • 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

Additional Information

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

40

About Us

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.

Equal Opportunity Employer

It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster.

If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailboxtasrecruit@humana.com for assistance.

Humana Safety and Security

Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailboxtasrecruit@humana.com to validate the request.

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