H-1B Visa Provider Relations Representative Jobs
Provider Relations Representative roles sit at the intersection of healthcare operations and network management, making them strong candidates for H-1B visa specialty occupation classification when the position requires a bachelor's degree in healthcare administration, business, or a related field. Employers in managed care, hospital systems, and insurance networks regularly sponsor H-1B visas for this role.
Find H-1B Visa Provider Relations Representative JobsOverview
Showing 5 of 13+ Provider Relations Representative jobs
See all Provider Relations Representative Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Provider Relations Representative roles.
Get Access To All JobsBecome 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.
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 H-1B Visa Provider Relations Representative Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new H-1B Visa Provider Relations Representative Jobs.
Get Access To All JobsTips for Finding H-1B Visa Sponsorship in Provider Relations Representative
Confirm your role meets specialty occupation
Pull the O*NET profile for Provider Relations Representative to document the degree requirements tied to the occupation. USCIS requires your specific position to demand at least a bachelor's degree in a directly related field, so generic job duties won't hold up without that documentation.
Target managed care organizations over staffing firms
Health plans, regional HMOs, and hospital network management divisions file LCAs directly as cap-subject employers. Staffing agency placements add H-1B dependency complexity, which tightens prevailing wage obligations and can slow your petition timeline significantly.
Look up prevailing wages before negotiating your offer
Use the OFLC Wage Search to check the Level I through Level IV wage tiers for your metro area before your offer letter arrives. Employers must pay at least the prevailing wage on your certified LCA, so knowing the floor helps you evaluate whether an offer is compliant.
Filter for verified H-1B sponsors on Migrate Mate
Search Provider Relations Representative roles on Migrate Mate to see employers with confirmed H-1B LCA filing history in healthcare network management. That history signals both sponsorship willingness and familiarity with the DOL certification process for your occupation.
Clarify H-1B transfer timing before your 60-day window closes
If you're leaving an H-1B job, a new employer can file a transfer petition and you can start working upon receipt, but only if you've maintained valid status. Don't wait until your last day to confirm your prospective employer is ready to file.
Request employer E-Verify enrollment confirmation early
STEM OPT employers must be E-Verify enrolled, and many healthcare networks already are, but verify it before you accept an offer if you're bridging from OPT. An employer that isn't enrolled can't legally employ you on STEM OPT while your H-1B petition is pending.
H-1B Visa Provider Relations Representative: Frequently Asked Questions
Does a Provider Relations Representative role qualify as a specialty occupation for H-1B purposes?
It can qualify, but the employer must demonstrate that the specific position requires at least a bachelor's degree in a directly related field, such as healthcare administration, business administration, or a clinical discipline. Roles at larger health plans and managed care organizations tend to have clearer degree requirements tied to the job duties, which strengthens the specialty occupation argument. Generic or entry-level coordinator titles with no degree requirement in the job posting are harder to support.
Which types of employers sponsor H-1B visas for this role?
Managed care organizations, regional health plans, hospital networks, and large physician management groups are the most active sponsors for Provider Relations Representative positions. These employers deal with credentialing, contract negotiation, and network compliance at scale, which creates sustained demand for the role. You can browse employers with verified H-1B LCA filing history for this occupation on Migrate Mate before targeting your applications.
How does the H-1B prevailing wage apply to Provider Relations Representative positions?
Your employer must certify through a Labor Condition Application that they'll pay you at least the prevailing wage for your occupation and work location before USCIS will approve the petition. The DOL sets four wage levels based on experience and supervisory responsibilities. Use the OFLC Wage Search to look up the current wage tiers for your metro area so you can evaluate any offer against the legal minimum before signing.
Can I transfer my H-1B to a new employer if I change provider relations jobs?
Yes, H-1B portability lets you move to a new employer once they file a transfer petition with USCIS and you receive the receipt notice, as long as your previous H-1B was approved and you've maintained valid status. You can start the new job upon receipt without waiting for approval. The key is timing: your new employer needs to have the petition ready to file on or before your last day with the previous employer.
Does working remotely affect my H-1B status as a Provider Relations Representative?
Remote work creates a worksite location issue under H-1B rules. Your employer's LCA must cover the geographic area where you actually work, not just their headquarters. If you'll be working from home in a different metro area than the one listed on your LCA, your employer may need to file an amended petition with USCIS and a new LCA for your home location. Confirm this with your employer before agreeing to any remote arrangement.