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Provider Relations Associate Jobs in Virginia (NOW HIRING)

Humana

Provider Relations Representative, LTSS/BH

Galax, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Humana

Provider Relations Representative, LTSS/BH

Galax, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Gig.com

Client Relations Associate - Entry Level

Norfolk, VA · On-site

$38K - $48K/yr

We provide paid training, ongoing mentorship, and professional development to help you succeed from ... Start your career as a Client Relations Associate with a company that values teamwork, professional ...

Humana

Provider Relations Representative, LTSS/BH

Tazewell, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Humana

Provider Relations Representative, LTSS/BH

Tazewell, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Humana

Provider Relations Representative, LTSS/BH

Bristol, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Humana

Provider Relations Representative, LTSS/BH

Bristol, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Humana

Provider Relations Representative, LTSS/BH

Galax, VA · On-site

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Become a part of our caring community The Provider Relations Representative (Provider Engagement ... Humana reserves the right to require associates to upgrade their internet service if necessary.

Cabela's

Customer Relations Associate - Part Time

Henrico, VA · On-site

$15 - $17.75/hr

  • Dental

  • Vision

  • Retirement

  • PTO

Customer Relations Associate The Customer Relations Associate performs various Customer Service ... Provides a legendary experience for every customer, every time by assisting customers in making ...

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Provider Relations Associate information

What is a provider relations associate?

Provider Relations Associates are professionals who serve as the primary point of contact between healthcare providers (such as doctors and hospitals) and insurance companies or healthcare organizations. Their main responsibilities include maintaining positive relationships with providers, addressing concerns or issues, educating providers about policies and procedures, and ensuring compliance with contracts. They play a key role in facilitating communication and resolving any disputes to ensure efficient healthcare delivery and satisfaction on both sides.

What are the key skills and qualifications needed to thrive as a provider relations associate?

To thrive as a Provider Relations Associate, you need a solid understanding of healthcare administration, contract management, and provider network operations, usually supported by a bachelor's degree in a related field. Familiarity with healthcare management systems, claims processing platforms, and proficiency in Microsoft Office Suite are commonly required. Strong interpersonal communication, negotiation, and problem-solving abilities are vital soft skills for building and maintaining positive relationships with healthcare providers. These competencies ensure effective collaboration, resolve issues efficiently, and support the overall performance of the provider network.

What are the main challenges provider relations associates face when working with healthcare providers?

Provider Relations Associates often navigate complex communication channels between healthcare providers and insurance companies. One common challenge is addressing concerns or resolving issues related to provider contracts, reimbursement, and compliance with policies. Balancing the needs of providers with organizational guidelines requires strong negotiation and problem-solving skills. Additionally, maintaining positive relationships while handling high volumes of inquiries and ensuring accurate documentation can make the role fast-paced and demanding, but also rewarding for those who enjoy dynamic, collaborative environments.

What is the difference between Provider Relations Associate vs Provider Relations Coordinator?

AspectProvider Relations AssociateProvider Relations Coordinator
Required CredentialsHigh school diploma or equivalent; some roles prefer healthcare or customer service experienceHigh school diploma; healthcare or administrative experience often preferred
Work EnvironmentOffice setting, healthcare organizations, insurance companiesOffice environment, healthcare facilities, insurance providers
Employer & Industry UsageHealthcare insurers, provider networks, managed care organizationsHealthcare insurers, provider networks, healthcare administration
Common Search & Comparison IntentYesYes

The Provider Relations Associate and Provider Relations Coordinator roles share similarities in work environment and industry usage, often involving communication with healthcare providers and supporting network relations. The main differences lie in responsibilities: associates typically handle basic provider inquiries and data entry, while coordinators may oversee provider onboarding and relationship management. Both roles require similar credentials and are vital in healthcare administration, making them common points of comparison for job seekers in this field.

What are the most commonly searched types of Provider Relations jobs in Virginia?

The most popular types of Provider Relations jobs in Virginia are:

What are popular job titles related to Provider Relations Associate jobs in Virginia?

For Provider Relations Associate jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Provider Relations Associate jobs in Virginia look for?

The top searched job categories for Provider Relations Associate jobs in Virginia are:

What cities in Virginia are hiring for Provider Relations Associate jobs?

Cities in Virginia with the most Provider Relations Associate job openings:

Provider Relations Associate jobs near you
Infographic showing various Provider Relations Associate job openings in Virginia as of August 2026, with employment types broken down into 100% Full Time. Highlights an 75% In-person, and 25% Remote job distribution.

Provider Relations Representative, LTSS/BH

Humana

Galax, VA • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 4 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 265 frontline employees who took The Breakroom Quiz

164th of 309 rated insurance

Job description

Become a part of our caring community
The Provider Relations Representative (Provider Engagement Professional) is responsible for day-to-day front line relationship management of network providers in Humana's Healthy Horizons in Virginia Medicaid network. This role supports provider onboarding, training, education, and inquiry/issue support resolution. This role specifically supports long-term services and supports (LTSS) and home and community-based services (HCBS) providers and must be based in Virginia. The individual in this role should have critical thinking/problem solving skills, understanding of health plan operations, and strong interpersonal skills.

Serve as primary relationship manager with assigned LTSS and HCBS providers to ensure positive provider experience with Humana Healthy Horizons 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 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 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

  • Must reside in Virginia (SW region includes, Lee, Wise, Washington and Galax)

  • Bachelors degree OR 1 - 5 years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience

  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies

  • Demonstrated ability to manage multiple projects and meet deadlines

Preferred Qualifications

  • Master's Degree

  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance

  • Comprehensive knowledge of Medicare policies, processes and procedures

  • Experience with Medicaid electronic visit verification (EVV)

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 atHumana.comand atCenterWell.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.

What Humana employees say

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About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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