Network Operations Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and preserve provider contract information and demographics for designated provider groups within the Health Plan.

• Foster provider relationships through collaborative services that support Provider Network Operations.

• Conduct roster audits.

• Serve as a customer service representative.

• Address and resolve provider loading challenges.

• Oversee allocated projects.

• Make decisions about work methods with limited supervision.

• Apply critical thinking skills to independently resolve issues.

• Complete necessary tasks utilizing strong time management and organizational capabilities.

• Adhere to established protocols and procedures.

⛳️ Requirements

• At least 2 years of experience in a healthcare environment working with providers, payors, healthcare facilities, etc.

• Experience in data analysis.

• Intermediate proficiency in Microsoft Office.

• Advanced skills in Excel.

• Capability to handle multiple tasks and thrive in a deadline-oriented setting.

• Reliable internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Dedicated workspace free from distractions to safeguard member PHI / HIPAA information.

• Preferred: Familiarity with APEX, PMDM, PAAG, or CRM systems.

• Preferred: Experience interpreting provider contracts.

• Preferred: Background in account management or project management.

• Preferred: Knowledge of medical claims.

🏝️ Benefits

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Personal wellness support.

• Work-from-home arrangement.

• Occasional travel to Humana offices for training or meetings.