[Hiring] Network Operations Coordinator @Humana

Role Description

The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Responsibilities include:

• Managing provider audits, provider service and relations, credentialing, and contract management systems.
• Executing processes for intake and managing provider perceived service failures.
• Making decisions regarding daily priorities for an administrative work group and/or external vendors.
• Coordinating work activities and monitoring progress towards schedules/goals.
• Overseeing the work of others and/or being the primary administrative owner of a main process, program, product, or technology.
• Working within broad guidelines with little oversight.

Qualifications

• Minimum of 2 years of experience working in a healthcare setting with providers, payors, healthcare facilities, etc.
• Data analytic experience.
• Intermediate skills with Microsoft Office, and proficient in Excel.
• Ability to multi-task and work in a deadline-driven environment.

Requirements

• Provider credentialing experience (preferred).
• Previous experience in claims (preferred).
• Prior contract review, loading, or interpretation experience (preferred).
• Work at Home Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps required.
  • Wireless, wired cable, or DSL connection is suggested.
  • Dedicated workspace lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• 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.
• Many other opportunities supporting whole-person well-being.