Green Card Provider Relations Representative Jobs
Provider Relations Representative roles at U.S. health plans and managed care organizations qualify for EB-2 or EB-3 green card sponsorship through the PERM labor certification process. Employers document recruitment efforts, file an I-140 petition, and sponsor you for permanent residency. Understanding how your credentials map to the right preference category strengthens your sponsorship case.
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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 (preferably in Charlottesville region)
- Bachelor's Degree
- 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)
Additional Information
Work at Home Internet Criteria
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 recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.
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, volunteer time off, 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 at Humana.com and at CenterWell.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.
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 (preferably in Charlottesville region)
- Bachelor's Degree
- 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)
Additional Information
Work at Home Internet Criteria
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 recommended; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.
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, volunteer time off, 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 at Humana.com and at CenterWell.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.
See all Green Card Provider Relations Representative Jobs
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Get Access To All JobsTips for Finding Green Card Sponsorship in Provider Relations Representative
Translate your credentials into PERM documentation
Gather official transcripts, degree equivalency evaluations, and employment verification letters before applying. PERM requires your employer to confirm your qualifications meet the job's minimum requirements, so gaps in documentation stall the process before it begins.
Target health plans with established PERM histories
Regional and national managed care organizations regularly sponsor Provider Relations Representatives through PERM. Search DOL's OFLC public disclosure data to identify employers who have filed labor certifications for this exact job title rather than guessing from job postings alone.
Use Migrate Mate to filter by sponsorship history
Filtering job searches by verified green card sponsorship saves weeks of manual research. Migrate Mate surfaces Provider Relations Representative openings at employers with documented EB-2 and EB-3 filing history, so you're applying where sponsorship is already established practice.
Check the prevailing wage before negotiating your offer
Your employer must pay at least the DOL prevailing wage for your location and job level. Use the OFLC Wage Search to look up the wage tier for your metro area before salary discussions so your offer clears the PERM threshold without renegotiation later.
Clarify EB-2 vs. EB-3 eligibility during the offer stage
Provider Relations roles typically require a bachelor's degree, placing most candidates in EB-3. Candidates with a master's degree or specialized experience in managed care contracting may qualify under EB-2, which can mean a shorter wait for certain nationalities. Confirm category placement with your employer before PERM is filed.
Understand that PERM locks in your priority date
USCIS assigns your green card priority date when your PERM labor certification is approved, not when your I-140 is filed. For EB-3 applicants from high-demand countries, that date determines your place in the queue, so earlier PERM approval directly affects how long you wait for permanent residency.
Green Card Provider Relations Representative: Frequently Asked Questions
Do Provider Relations Representative roles qualify for EB-2 or EB-3 green card sponsorship?
Most Provider Relations Representative positions qualify under EB-3 because they typically require a bachelor's degree in healthcare administration, business, or a related field. Candidates holding a master's degree or demonstrating specialized expertise in managed care contracting, provider network development, or claims adjudication may qualify under EB-2. Your employer documents the minimum requirements during the PERM labor certification filing, so the job description language matters for determining which category applies.
How does green card sponsorship differ from H-1B sponsorship for this role?
Unlike H-1B visa, EB-2 and EB-3 green card sponsorship leads to permanent residency rather than a temporary work period, and there's no annual lottery at the EB-3 level. The PERM process requires your employer to conduct a formal recruitment test and file a labor certification with DOL before petitioning USCIS. Timelines are longer overall, but you're building toward permanent status rather than renewing every few years with no guarantee of continuation.
How can I find Provider Relations Representative jobs where the employer already sponsors green cards?
Migrate Mate lets you search specifically for Provider Relations Representative openings at employers with verified EB-2 or EB-3 sponsorship history, so you're not wasting applications on roles where sponsorship is uncertain. Filtering by sponsorship type upfront is especially useful in healthcare administration, where PERM activity varies significantly between regional health plans, national managed care organizations, and third-party administrator firms.
What does the PERM labor certification process look like for a Provider Relations role?
Your employer files a PERM application with DOL after completing a formal recruitment period, which typically includes job postings, newspaper ads, and internal notices. DOL reviews whether qualified U.S. workers were available. Once certified, your employer files an I-140 immigrant petition with USCIS. The entire PERM and I-140 stage can take one to two years before you reach adjustment of status or consular processing.
Can my employer start the PERM process while I'm working on an H-1B or other nonimmigrant status?
Yes. Employers routinely file PERM labor certifications for employees already working on H-1B, L-1 visa, or other nonimmigrant statuses. The PERM filing doesn't affect your current work authorization, and getting an early start locks in your priority date. If your H-1B reaches its six-year limit before your green card is approved, an approved I-140 or a pending PERM filed more than 365 days earlier can qualify you for H-1B extensions under AC21 rules.