Become a Part of Our Caring Community
At Humana, we put health first — for our members, our communities, and our team. We’re seeking a Network Operations Professional to help ensure the accuracy of provider data and support the efficiency of our healthcare service operations.
Role Overview
In this role, you will support provider relations and data management, helping to maintain operational excellence within the network. You’ll play a key part in managing service issues, ensuring data accuracy, and aligning with strategic initiatives across departments.
Key Responsibilities
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Maintain and update provider data (e.g., demographics, rates, contracts)
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Manage provider audits, credentialing, and contract lifecycle
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Track and resolve provider service issues and perceived failures
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Use SQL, Excel, and Access to analyze provider claims data
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Ensure accuracy across contract and credentialing systems
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Interpret operational strategies and make decisions within scope
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Follow established workflows while applying critical thinking to improve processes
Required Qualifications
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Must be available to work during Eastern Standard Time (EST) hours
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3+ years of experience in provider network management
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Advanced skills in Excel, Access, and other Microsoft Office applications
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Hands-on experience with SQL for data querying and analysis
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Experience managing mid to large-scale projects
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High attention to detail and analytical problem-solving skills
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Dedicated remote workspace with high-speed internet (minimum: 25 Mbps download / 10 Mbps upload)
Preferred Qualifications
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Bachelor’s degree
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Experience with Service Fund processes
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PMP or PMI-ACP certification
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Familiarity with healthcare data and large data sets
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Experience using SAS and/or SPSS
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Intermediate to advanced skills in statistical programming and analytics
What Humana Offers
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Day-1 benefits including Medical, Dental, Vision, and 401(k)
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Tuition assistance, paid parental leave, and caregiver leave
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Paid time off (PTO), company holidays, and volunteer days
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Competitive base salary with bonus incentive eligibility
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Work-from-home flexibility with occasional travel to Humana offices for training or meetings
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Support for career growth and development in a purpose-driven environment
Interview Process
Shortlisted candidates will be invited to complete a pre-recorded voice or text-based interview using HireVue. This virtual interview allows you to record your responses at your convenience (typically takes 10–15 minutes).
About Humana
Humana Inc. (NYSE: HUM) is a leading health and well-being company committed to providing care that’s accessible, effective, and human. We serve millions of individuals through Medicare, Medicaid, individual health plans, and CenterWell healthcare services.
Equal Opportunity Employer
Humana is proud to be an equal opportunity employer. We are committed to equity and inclusion for all, regardless of race, color, religion, gender, sexual orientation, gender identity, age, disability, or veteran status.
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