Jobs and Careers
HU

Provider Data Management Professional

Humana
Remote US, United States, United StatesRemotefull_timeVerifiedPosted 24 Jan 2025
💰 $75,300/yr($55,200/yr$75,300/yr)

About the role

Become a part of our caring community and help us put health first
 

The Provider Business Intelligence teams are committed to effective and efficient business solutions for quality assurance and risk mitigation in implementing Humana’s Provider Medicare/Medicaid contracts. We are in search of a Business Intelligence Engineer 1 to provide support to our Provider Facility and Physician accounts to ensure we are meeting contractual requirements and expected timelines for the respective contracts.

Job Description

The Business Intelligence Engineer 1 provides support to provider or facility accounts by loading contracts, responding to inquiries and resolving issues of concern.  This role performs set-up, database loading, and preparation of administrative documents/materials for Provider Facility or Physician accounts/contract loads.  As a Business Intelligence Engineer you can expect to research, identify and correct contract loading errors to decrease claims payment issues.  Facility or Physician arrangements and interpretations will be revised; followed by loading them into Humana systems.

As a Business Intelligence Engineer 1 you will communicate with all system users and market office staff regarding, but not limited to; inquiries, change in contracts and system status reports.  A successful candidate will have high quality communication skills (written and verbal), top-notch organizational skills with attention to detail, and ability to maintain multiple competing priorities.


Use your skills to make an impact
 

Required Qualifications

  • 1+ years of Provider Installation Experience (credentialing, contracts, provider database/directories, or related area)
  • 1+ years experience in a metric/production driven environment
  • Prior professional experience using Microsoft Office Programs, including Word, Excel, PowerPoint
  • Must meet Humana's Work at Home connectivity requirements listed in additional information
  • Meet location requirements identified in additional information

Preferred Qualifications

  • Associates or Bachelors Degree
  • CAS, MTV, PAAG, or APEX systems experience
  • Claims experience
  • Provider data management data loading/analysis/review

Additional information

Hours:  7a-9am start time; OT based upon business need (can complete during work week/weekend) No PTO month of July due to Medicare-Push season

Training: 5 week virtual class room training

Location: Remote US

To maximize the investment in our talent and support associates success in achieving competency levels which enable associates to understand scope of process and make connections with other areas of the enterprise, the Provider Contract Team has a time-in-job commitment of 18 months.

Interview Format

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.

Work at Home Statement

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 required; 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.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter by visiting go/Buzz and searching Ask A Recruiter or email askarecruiter@humana.com. Please be sure to provide the requisition number so we may be able to research your request quicker.

This is a remote pos

Apply for this role

Generate a tailored application kit with a matched cover letter, interview prep, and CV highlights — in under 60 seconds.

Apply Now →Generate Application Kit

Free account required — sign up in 30s

Company

Humana

View company profile →