1+ months

Network Operations Professional 2

Humana
Portsmouth, NH 03801
Description The Network Operations Professional 2 is primarily responsible for Northeast Region Operational reporting and Provider data integrity management The Network Operations Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Responsibilities The Network Operations Professional 2 is the lead for the Northeast Region network adequacy and expansion submissions and is the liaison between the region leadership and corporate Network team . This person will work with Contracting Directors and Contractors to develop contracting scenarios and assist in identifying providers that will close network gaps. This person is responsible for provider data for all Northeast Medicare and Commercial networks but not limited to demographics, rates, and contract intent. This person will develop provider data audits, provider analysis and maps. The person in this role will understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Required Qualifications + Bachelor's degree + Experience working with healthcare provider data + Demonstrated expertise in data preparation and analysis using Excel, Access and other Microsoft applications + Prior experience managing mid to large scale projects + Strong Attention to Detail + Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications + Service Fund experience strongly desired + Experience and understanding of Medicare network adequacy + PMP desired + Previous experience in the health solutions industry + Knowledge of Maptitude + Knowledge and Experience of Tableau Additional Information This position will be "work at home", however, you must live within driving distance of the New York City office for occasional meetings, etc. Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2020-05-22 Expires: 2020-07-22

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Network Operations Professional 2

Humana
Portsmouth, NH 03801

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