Provider Network Operations Coordinator 3- Minnetonka MN

Profile

Description

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

Responsibilities

The Network Operations Coordinator 3 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 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.

Some Job responsibilities:

Contract load auditing

Network adequacy analysis

Provider reporting tools

Required Qualifications

1 or more years of provider relations experience or healthcare insurance and/or Medical front office experience or related experience

Intermediate skills with Microsoft Word and Excel

Ability to work in a deadline driven environment

Monday- Friday 8am-5pm

Work At Home (WAH) - Temporary Due to COVID-19 emergency. Please note this permanent position allows you to work at home indefinitely until further notice. See additional information in section below.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Associates degree or higher education

Prior experience working in the healthcare insurance industry

Contract experience

Previous experience in claims

Prior contract interpretation experience

Familiarity with CAS system

Additional Information

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text/Voice, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time.

These requirements include:

Access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m

Dedicated secure home workspace for interview or work purposes.

Humana continues to monitor the situation, and will adjust service levels as the corona virus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and well-being during the hiring process.

Internal -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.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com