Provider Data Management and Contract Loader

San Antonio, Texas, United States

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Full TimeJob Type

UnknownVisa

Healthcare, InsuranceIndustries

Requirements

Candidates should have prior healthcare industry experience and intermediate knowledge of Microsoft Office applications, including Excel and Word. Excellent written and verbal communication skills, keen attention to detail, and strong organizational and critical thinking skills are also required. Preferred qualifications include an associate's or higher degree and experience in contracting or operations within the healthcare industry, as well as familiarity with APEX, CAS, MTV, PIMs, and the claims process.

Responsibilities

The Provider Data Management and Contract Load Professional 1 will perform data maintenance for the Provider Data Management System and support various functions within the North Medicaid and Medicare markets. Responsibilities include set-up, database loading, preparation of administrative documents, responding to provider inquiries, resolving issues, and ensuring accurate and timely updates to provider data. This role also involves creating provider records, maintaining database integrity and quality assurance, entering demographic information, collaborating with other departments on provider updates, and assisting with ad hoc projects.

Skills

Provider Data Management

Contract Loading

Database Management

Microsoft Office

Data Entry

Quality Assurance

Problem Solving

Collaboration

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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