Network Operations Coordinator

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

📋 Description

• Oversee provider data for health plans, encompassing demographics, rates, and contract intentions.

• Conduct provider audits.

• Manage provider services and relationships.

• Supervise credentialing and contract management systems.

• Implement processes for the intake and management of provider-perceived service failures.

• Prioritize requests while interpreting or adapting administrative procedures, processes, and techniques.

• Accomplish administrative tasks and projects with minimal guidance.

• Occasionally travel to Humana offices for training or meetings.

⛳️ Requirements

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

• Intermediate proficiency in Microsoft Office.

• Strong skills in Excel.

• Capacity to handle multiple tasks and work within a deadline-driven environment.

• Ability to work from a dedicated space free from ongoing interruptions to ensure the protection of member PHI / HIPAA information.

• Self-provided internet service with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Suggested connection type is wireless, wired cable or DSL.

• Experience in provider credentialing is preferred.

• Prior experience in claims is advantageous.

• Previous experience with contract review, loading, or interpretation is preferred.

🏝️ 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.

• Smart healthcare decision support.

• Occasional travel to Humana offices for training or meetings.