Humana

About Humana

 

Job Category:

Market Strategy - Operations

Country:

United States

Postal Code:

10001

Approximate Salary:

Not Specified

Position Type:

Full Time

Network Operations Coordinator 4

Humana - New York, New York

Posted: 12/7/2018

Description

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.

Responsibilities

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.

               

Required Qualifications

  • 2+ years of previous provider experience (provider contract, provider relations, or provider service)
  • Proficiency in MS Office applications to include Word, PowerPoint, Excel (pivot tables)
  • Experience working in healthcare/health insurance
  • Possess a strong attention to detail
  • Ability to work in a deadline driven environment
  • Strong verbal and written communication skills
  • Previous account management or project management experience
  • Valid drivers license and reliable transportation

Preferred Qualifications

  • Associate's Degree
  • Provider contract interpretation experience
  • Previous account management or project management
  • Knowledge with medical claims

Additional Information

Must live within the Northeast Region (ME/NH/NY/NJ)

Scheduled Weekly Hours

40

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