Network Operations Coordinator 4
Remote US
The Network Operations Coordinator 4 maintains provider data to support customer service activities through data integrity management and gathering of provider data needed for service operations. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.
The Network Operations Coordinator 4 manages and maintains provider contract data and demographics for assigned provider groups. 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. All other duties as assigned.
Use your skills to make an impact
Required Qualifications
2+ years of provider relations experience, healthcare services or related experience
Intermediate in Microsoft Word, Outlook, Excel and TEAMS
1+ years of experience managing mid to large scale projects
Preferred Qualifications
Bachelor’s Degree
Advanced experience with Microsoft Excel
Provider contract interpretation experience
Previous account management or project management
Knowledge with medical claims
Ability to accommodate a work schedule 8:00 a.m. – 5:00 p.m. following Central Standard Time zone hours
Additional Information
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
WAH / Internet Guidance:
To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
ApplyJob Profile
California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Internet speed requirements Montana Must accommodate Central Standard Time hours Remote US South Dakota Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota
Benefits/Perks401k retirement 401k Retirement Savings Caring community Competitive benefits Dental Disability Holidays Internet expense reimbursement Life Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Smart healthcare decisions Support whole-person well-being Telephone equipment provided Time off Vision Vision Benefits Volunteer time Volunteer time off Work From Home Work From Home Flexibility
Tasks- Customer support
- Data Integrity Management
- Interpretation
- Maintain provider data
- Manage projects
- Manage provider relationships
- Perform roster audits
- Project management
- Resolve provider load issues
- Time management
- Training
Account management Administrative Audits BI Business Claims Compensation Critical thinking Customer service Customer Support Data Data integrity Data Integrity Management Dental Excel Healthcare Healthcare services HIPAA Initiative Insurance IT Leadership Life Insurance Management Medicaid Medical claims Medicare Microsoft Microsoft Excel Microsoft Outlook Microsoft Teams Microsoft Word Network Operations Organizational Outlook Policy Project Management Provider Relations Recruitment Security Teams Technology Time Management Training Vision Wellness Word
Experience2 years
EducationAssociate Bachelor's degree Business Education Healthcare Higher IT Management Operations
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9