Humana is hiring a Tricare Community Liaison (TCL) to serve as a key customer-facing representative for the TRICARE health plan in the East Region. This role develops and sustains collaborative relationships with TRICARE beneficiaries, Medical Treatment Facility (MTF) staff, government personnel, and healthcare providers.
What You'll Do
- Provide accurate explanation of TRICARE health plan policies and procedures during on-site and electronic outreach, ensuring compliance with customer support standards.
- Respond to inquiries from beneficiaries, providers, and Government regarding eligibility, enrollment, billing, claims, referrals/authorizations, appointment assistance, network operations, access to care, and policy.
- Research and resolve difficult, complex TRICARE problems elevated by Government agents, beneficiaries, or providers within required timelines.
- Assist in developing and sustaining a high-performing provider network in designated Prime Service Areas (PSAs) and Non-Prime Service Areas (NPSAs), including conducting market laydown assessments.
- Accomplish administrative tasks 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.
What We're Looking For
- 2 or more years of experience in customer relations, public contact, and/or TRICARE experience, including making presentations to groups.
- Experience handling a high volume of customer contacts in a courteous and professional manner.
- Demonstrated ability to analyze information, research problems, and determine and implement solutions.
- Ability to multi-task and work in a very fast-paced environment.
- Strong written and verbal communication skills, including presentation skills.
- Excellent interpersonal skills and ability to develop collaborative working relationships across multiple functional areas.
- Consultative skills including ability to assess, understand the consumer, and make recommendations.
- Ability to interpret and understand policy and/or government contracts (e.g., TRICARE, Medicare, Medicaid, CMS).
- Comprehensive knowledge of Microsoft Office Suite including Word, Excel, OneNote, PowerPoint, and/or Access.
- Willingness to travel and work uncommon hours. Must be flexible and have reliable transportation.
- Proven ability to deliver clear and concise information, adapt content to audience needs, and manage Q&A sessions for audiences of active-duty, retirees and families.
- U.S. citizenship is required per Department of Defense Contract.
- Must successfully receive approval for government security clearance (Via National Background Investigation Services NBIS).
- Must live within a 30–40-mile radius of the Aberdeen Proving Ground, MD market.
Nice to Have
- Experience with TRICARE contracts and/or the military health care delivery system.
- Knowledge of TRICARE policies and benefits.
- Prior experience in a medical office setting.
- Experience with medical claims/health insurance.
- Experience in Provider relations.
- Bachelor's degree.
Technical Stack
- Microsoft Office Suite: Word, Excel, OneNote, PowerPoint, Access
Team & Environment
You will be assigned to specific Health System Areas comprised of Prime Service Areas (PSAs) and Non-Prime Service Areas (NPSAs). You may be designated as an embedded associate at an MTF and may provide back-up coverage for the Health System Operations Leader.
Benefits & Compensation
- Compensation range: $64,600 - $75,000 per year
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- Paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave
- Short-term and long-term disability
- Life insurance
- Bonus incentive plan based on company and/or individual performance
Work Mode
This is a hybrid position. Work locations include Remote/Work at Home, Aberdeen Proving Ground, MD, Glen Burnie, MD (Baltimore Coast Guard), Northern Virginia, Washington D.C., and Maryland.
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.
