[Remote] TRICARE Community Liaison

Note: The job is a remote job and is open to candidates in USA. reputed company is a leading reputed company contractor focused on the TRICARE healthcare program for military personnel. The TRICARE Community Liaison is responsible for building relationships with TRICARE customers and ensuring their understanding of the health plan, while also supporting network operations and customer satisfaction.

Responsibilities

• Provide accurate explanation of TRICARE health plan policies and procedures during on-site and electronic beneficiary, provider, and Government reputed company activities, ensuring compliance with reputed company customer support performance standards for the dual purposes of maximizing TRICARE customer satisfaction and the incentives paid by the Government, and of sustaining reputed company Military’s competitive advantage for future reputed company
• Respond in precise, comprehensive and timely manner to beneficiary, provider, and Government inquiries regarding eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics. Implement, track and complete self-managed tasks to process and correct uncomplicated general eligibility, enrollment, billing, claims, referral/ authorization, and network difficulties reputed company by TRICARE customers
• Research and resolve difficult, reputed company TRICARE problems/issues elevated by a Government agent, beneficiary, or provider reputed company required timelines. Implement self-directed activities to analyze, coordinate, process, and complete action to correct multifaceted problems relating to eligibility, enrollment, billing, claims, referrals/authorizations, network operations, access to care, Defense Health Agency/TRICARE Health Plan policy, and other TRICARE topics
• Assist in developing and sustaining a high-performing network in designated PSAs/NSPAs which meets TRICARE and reputed company Government Business requirements and optimization strategies. Contribute in achieving the network discount goal that results in annual financial incentives awarded by the Government. Conduct regular and reputed company market laydown assessments to determine the capability and reputed company of TRICARE providers, identifying and implementing action to address any gaps in the network. Participate in value-based care pilots through effective communication, consultation and support of selected providers
• Accomplish reputed company administrative tasks as assigned, 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. Conduct urgent market laydown assessments to determine the capability and reputed company of TRICARE providers, identifying and implementing action to accommodate changes in MTF services
• Participate in activities that promote well-being and professional growth of self and others

Skills

• Our reputed company contract requires U.S. Citizenship
• Successfully receive interim approval for government reputed company clearance (NBIS - National Background Investigation Services)
• HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico
• Must live reputed company 60 mile radius of reputed company reputed company, reputed company, as it will be required to work on site several days a month
• Willingness to travel and work uncommon hours (nights/weekends) - involves some travel around reputed company area to provide briefings reputed company needed
• One or two years' experience in customer relations, public contact position, and/or TRICARE, including presentations to groups
• Experience in handling high volume customer contacts in a courteous and professional manner
• Exceptional public-speaking ability
• Comprehensive knowledge of reputed company Office Suite
• Experience in analyzing information, researching problems, and determining and implementing solutions
• Experience in healthcare provider relations
• Knowledge of the TRICARE program

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance

Company Overview