Humana Network Operations Coordinator 4 in Boston, Massachusetts
The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management and gathering of provider claims 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 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 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.
2+ years of previous provider experience (provider contract, provider relations, or provider customer service)
Proficiency in Microsoft Office: Word, PowerPoint and Excel
Analytical thinking and/or root cause analysis
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
High School Diploma
Experience interacting with providers
Proven track record with building and maintaining provider relationships
Previous account management or project management
Experience using multiple operating systems to research and manage data integrity
Knowledge with medical claims
2 or more years of provider relations experience
Previous experience with auditing providers
Experience working special projects
EST or CST working hours
Possible overtime, Hours subject to change based on business need.
As part of our hiring process for this opportunity, we will be using an interviewing technology called Montage Text Messaging to enhance our hiring and decision-making ability. This 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. If you are selected to move forward, you will receive a text correspondence inviting you to participate in a Text Message screen. You should anticipate this interview to take about 5 to 10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to the next round of interviews.
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
Dedicated secure home workspace for interview or work purposes.
Humana continues to monitor the situation, and will adjust service levels as the corona virus 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 well-being during the hiring process.
If you have additional questions regarding this role posting, 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.
Scheduled Weekly Hours
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