Network Operations Coordinator 3

Humana
$44,900 - $60,200Remote

About The Position

The Network Operations Coordinator 3 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 manage provider perceived service failures. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.

Requirements

  • 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
  • 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.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

  • Provider credentialling experience
  • Previous experience in claims
  • Prior contract review, loading or interpretation experience

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 manage provider perceived service failures.

Benefits

  • medical
  • dental
  • 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
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