Humana

About Humana

 

Job Category:

Market Strategy - Operations

Country:

United States

Postal Code:

33548

Approximate Salary:

Not Specified

Position Type:

Full Time

Senior Network Adequacy Reporting Analyst

Humana - Lutz, Florida

Posted: 11/14/2018

Description

The Senior Network Adequacy Reporting Analyst tests the overall network in each county of operations to ensure the network is strong enough to support serving customers. The Senior Network Adequacy Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Network Adequacy Reporting Analyst begins to influence department’s strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Handles network adequacy analysis for the Florida Medicaid line of business.

               

Requirements:

  • Requires a BA/BS degree in a related field
  • 5-8 years of data file/reporting experience, using analytics and/or relational databases
  • Advanced proficiency with MS Excel
  • Experience / working knowledge of provider networks
  • Experience with Network Analysis software and reporting (GeoAccess, Disruptions, Average Discounts, CPT/DRG analyses)
  • Knowledge of regulatory reporting on provider networks
  • Able to complete manual review of disruptions to ensure data integrity and improve accuracy of results
  • Excellent verbal and written communication skills
  • Experience working with Provider Network and Compliance teams in a consultative role

Preferred:

  • Experienced user of Microsoft Access and SQL programming
  • Proficiency with Quest Analytics software

Scheduled Weekly Hours

40

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