Supervisor, Network Operations

DescriptionThe Supervisor, Network Operations maintains provider relations to support Market contracting activities through data integrity management and gathering of provider contract submissions data needed for service operations.ResponsibilitiesThe Supervisor, Network Operations 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.

Escalated issues internal and external customers

Support, Training and coaching team

Passionate about contributing to an organization focused on continuously improving consumer experiences

Required Qualifications

Bachelor's Degree

5+ years of provider network and/or provider contracting experience

2+ years of experience with contract loading and/or auditing

Experience working with Medicare, Medicaid and other reimbursement methodologies

Experience with Microsoft Excel that includes comparison, v-look up, etc.

Ability to manage multiple projects with tight deadlines

Knowledge of Medicaid

Preferred Qualifications

Prior experience collaborating with teams to build upon and improve existing systems/processes

Experience with ACO/Risk Contracting

Strong Humana provider system knowledge of CAS/MTV/PIMS/ Credentialing /Service Fund/CIS/Claims Explorer/ PICA Report

Experience in a team leadership and/or supervisory position

Experience in assigning work, overseeing productivity

Demonstrated capability with leading, coaching, and developing associates formally or informally

Microsoft Access

Additional Information

M-F 8-5 CST

Travel based on business needs

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Work-At-Home RequirementsThis is a remote position#LI-Remote Work at Home GuidanceTo ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

Satellite, cellular and microwave connection can be used only if approved by leadership

Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer 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 Hours40Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.