Network Operations Coordinator 4

Humana

1d•$53,100 - $72,500•Remote

About The Position

The Network Operations Coordinator 4 manages and maintains provider contract data and demographics for assigned provider groups for the Health Plan. Manages provider relationships through shared services that supports Provider Network Operations. This includes, but is not limited to: Performing Roster Audits, Acting as a customer service liaison, Resolving provider load issues, Managing Projects as assigned. Makes decisions regarding own work methods and requires minimal direction. Uses critical thinking to solve problems, works independently with strong time management and organizational skills to complete required work. Follows established guidelines and procedures.

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

Experience with APEX, PMDM, PAAG or CRM
Provider contract interpretation experience
Previous account management or project management
Knowledge of medical claims

Responsibilities

Performing Roster Audits
Acting as a customer service liaison
Resolving provider load issues
Managing Projects as assigned

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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