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

Humana is seeking a Provider Data Management and Contract Load Professional 1 to support the North Medicaid and Medicare markets. This position performs data maintenance for Provider Data Management System and supports various functions within the Medicaid and Medicare Market for all lines of business (Medicare, Medicaid, and Long Term Services and Support), including but not necessarily limited to supporting Provider Network Development and Credentialing.

The Provider Data Management & Contract Load Professional 1 performs set-up, database loading, and preparation of administrative documents and materials. Provides support to provider accounts by responding to inquiries and resolving issues of concern.

• Maintains accurate, up to date provider data in the Provider Data Management System (PDMS)
• Works in collaboration with other staff to ensure that all provider updates (adds, changes, delete) requests are researched, analyzed, responded to, and completed in an accurate and timely manner
• Creates Provider records in the PDMS from received applications
• Maintains standards for database integrity and quality assurance
• Enters provider demographic information for requests within the PDMS
• Works collaboratively with other departments regarding Provider updates
• Assists with ad hoc projects

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
• And more

Use your skills to make an impact
 

Required Qualifications

• Prior health care industry experience
• Knowledge and intermediate experience of Microsoft Office applications to include Excel and Word
• Excellent written and verbal communication skills
• Keen attention to detail
• Strong organizational and critical thinking skills

 

Preferred Qualifications

• Associates or higher-level degree
• Prior health care industry experience in the areas of contracting or operations
• Experience in APEX, CAS, MTV, PIMs and claims process

 

Additional Information

• Minimum of 18-month commitment in role
• Workstyle: Remote. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.  
• Typical Work days/hours: must be available to start between business hours 6-9 am Monday – Friday, Eastern Standard Time (EST)
• This position is located in the Continental US

Work at Home/Remote Requirements

Work-At-Home Requirements

• To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
  • Wireless, Wired Cable or DSL connection is suggested.
  • Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership.  (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
  • Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota.  Associates 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 associates 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

Our Hiring Process

As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendo