Sr Provider Installation Professional - Remote Nationwide

Profile

Description

Responsibilities

As part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms that align with Service Fund capabilities and contracting goals.

Will identify, devise, or modify processes to support complex contractual agreements.

Will be accountable for loading national and market specific contracts, including initial associations.

Will work in close coordination with PCP Contract Load, Capitation Rates, Payments, and Balance Adjustments teams to ensure accurate contract implementation.

Required Qualifications

Minimum 1 year experience in Service Fund Operations to includeprovider contract interpretation, legal terminology, and/or Provider Value Based financial analysis

Experience in data management, data extraction, and data reporting

Comprehensive knowledge of MS Office desktop applications (Word, Excel, PowerPoint)

Excellent oral and written communication skills

Experience managing projects in a deadline driven area

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

If progressed to offer, you will be required to:

Provide proof of full vaccination OR

Commit to weekly testing, following all CDC protocols, OR

Provide documentation for a medical or religious exemption consideration

Preferred Qualifications

Bachelor's or advanced degree

Experience utilizing SQL to pull and review data elements

Extensive knowledge of multiple types of coding systems (CPT, HCPCS, ICD-10, Humana internal code sets)

Comprehensive knowledge of relational databases and programming with SQL and/or Visual Basic

Experience with healthcare information technology and actuarial science

Experience working with Senior Leaders and influencing strategic decisions

Work-At-Home Requirements

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40

Company info

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