LTSS Provider Representative - Remote In-Field Marion Co.

Description

Title: LTSS Provider Representative
Location: Remote within Marion and surrounding counties — 50% travel required
Schedule: Standard business hours M-F 8am-5pm

About the Role

As an LTSS Provider Representative, you’ll be the primary connection between our health plan and the LTSS provider network. You’ll help providers navigate processes, resolve operational challenges, and access the resources they need to deliver high-quality care. This role blends relationship-building, problem-solving, and education to support provider growth, retention, and compliance.

What You’ll Do

• Build and maintain strong relationships with Home and Community-Based Services (HCBS) and LTSS providers through email, phone, and in-person visits.
• Share program updates, administrative changes, and training opportunities.
• Support providers in resolving claims, service, and operational issues by connecting them with the right internal teams.
• Conduct site visits to assess readiness, ensure network adequacy, and address service initiation and timely access needs.
• Partner with contracting and other departments to recruit, onboard, and retain LTSS providers.
• Lead or participate in provider education sessions, webinars, and office hours.
• Monitor provider contract compliance, reimbursement policies, and state/regulatory requirements.
• Assist with provider recruitment strategies to meet network needs in assigned regions.
• Provide data and insights during contract negotiations.
• Represent the organization at provider seminars or presentations for state Medicaid agencies or provider associations.

Requirements

Minimum Requirements

• Bachelor’s degree preferred and at least 3 years of customer service experience in a provider environment or as a trainer.
• Or an equivalent combination of education and experience.
• Strong skills in communication, organization, and accountability and comfortable in a team environment

Preferred Skills & Experience

• Experience working directly with providers to develop strategies that improve outcomes.
• Strong Medicaid LTSS claims knowledge.
• Proficiency in Microsoft Office, especially PowerPoint and Excel.
• Comfortable presenting to groups of various sizes.
• Prior experience in community/home care