Network Operations Coordinator 4

Profile

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 made 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 or more years of provider relations experience

Intermediate in Microsoft Word and Excel

Valid drivers license and reliable transportation with the ability to travel to providers offices within the region up to 25% of the time

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

Preferred Qualifications

Provider contract interpretation experience

Understanding of healthcare claims

Previous account management or project management

Additional Information

The preferred candidate will live in either Alabama or Tennessee, however, remote candidates, nationwide, will be considered for this role.

Scheduled Weekly Hours

40

Company info

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