Network Operations Coordinator 4

Employment Type: Full-time Location Type: Remote (with occasional travel) Pay Range: $53,100 - $72,500 per year

Position Overview

Become a part of our caring community and help us put health first. The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. This role assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The position will cover the Oklahoma Market.

Responsibilities

• Manages provider data for health plans, including but not limited to demographics, rates, and contract intent.
• Manages provider audits, provider service and relations, credentialing, and contract management systems.
• Executes processes for intake and manages provider perceived service failures.
• Makes decisions regarding daily priorities for an administrative work group and/or external vendors, including coordinating work activities and monitoring progress towards schedules/goals.
• Often oversees the work of others and/or is the primary administrative owner of a main process, program, product, or technology.
• Works within broad guidelines with little oversight.

Required Qualifications

• 2+ years of provider relations, customer support, administrative, data entry, or related experience.
• Intermediate skills with Microsoft Word and Excel.
• Ability to work in a deadline-driven environment.
• Strong attention to detail.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

• Provider contract interpretation experience.
• Previous account management or project management experience.
• Previous experience in health insurance or healthcare.
• Experience with Medicaid.

Additional Information

• Travel: Ability to travel up to 10% annually. Occasional travel to Humana's offices for training or meetings may be required.
• Work At Home / Internet Information:
  • Self-provided internet service must meet the following criteria: at minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required. Wireless, wired cable, or DSL connection is suggested. Satellite, cellular, and microwave connections can be used only if approved by leadership.
  • Employees who live and work from Home in California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide telephone equipment appropriate to meet the business requirements for the position.
  • Must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Interview Technology: HireVue will be used as part of the hiring process.
• SSN Information: Applicants may be asked to provide their Social Security Number if it is not already on file. An email from Humana@myworkday.com will be sent with instructions if required.

Description of Benefits

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