Network Operations Coordinator 4 - Work at Home Nationwide

Profile

Description

The Network Operations Coordinator contributes to the provider experience by managing the accuracy of the provider data within the health plan networks. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

The Network Operations Coordinator (NOC) 4 is an important part of the regional Provider Development team and is accountable for maintaining accurate data for assigned providers. This may include path-to-value and value-based contracts. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees 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

Associates Degree

In lieu of Associates Degree, 2 years experience working with provider data, provider directories, and/or contract management

Intermediate in Microsoft Excel

Flex start in EST

Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills including ability to learn new computer programs

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance for Humana systems is 10Mx1M

Preferred Qualifications

Bachelor's Degree

2 years of provider relations experience OR provider loading experience

6 months of Apex knowledge

Provider contract interpretation experience

Previous account management or project management

Previous network operations experience

Knowledge with medical claims

Knowledge of PMDM, PAAG and CAS

Knowledge of Service Fund

Additional Information

Work at Home New York is preferred but additional locations will be considered.

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com