Network Operations Coordinator 3

Description

The Network Operations Coordinator 3 maintains provider relations to support customer service activities through data integrity management and gathering of information needed for service operations. The Network Operations Coordinator 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

The Network Operations Coordinator 3 manages provider data for health plans including but not limited to demographics 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 typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.  Works with both external and internal Partners to ensure Directory accuracies.  Achieves established deadlines and provides accurate and up to date information to our clients.

Required Qualifications 

• High School Diploma
• 1 + years of experience analyzing provider data, work with provider contracts, etc.
• Proficient Microsoft Word and Excel (able to create spreadsheets/reports, VLookups and Pivot Tables)
• Ability to work a schedule between the hours of 7 – 6 MST or CST
• Ability to work in a deadline driven environment
• Proven ability to work independently
• Ability to navigate multiple systems gathering data

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Preferred Qualifications

• Bachelor's Degree
• Prior contract interpretation experience

Additional Information

This is a remote position 

#LI-Remote 

Work at Home Guidance

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; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• 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

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.

As part of our hiring process for this opportunity, we will be using an  interviewing technology called Montage Voice 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. 

Scheduled Weekly Hours

40

Pay 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$40,200 - $55,200 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

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 p