Network Operations Lead
Humana
7,155 reviews
Tampa, FL 33610
Remote
Full-time
Humana
7,155 reviews
Read what people are saying about working here.
Job details
Job Type
Full-time
Full Job Description
The Lead, Network Operations works on problems of diverse scope and complexity ranging from moderate to substantial in the Provider Network/Provider Development space.
Responsibilities
The Lead, Network Operations maintains access control, provider network compliance, corporate network initiatives, provider data integrity, provider load processes. Monitors, tracks and records market and regional performance and utilization metrics. Communicates highly complex information to both peers and leadership. May participate in development of regional processes and compliance functions. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
• 8 or more years of Provider Network Operations experience (provider network compliance, corporate network initiatives, provider data integrity, provider load processes)
• 2 or more years of project leadership experience
• Working knowledge of all Microsoft Office applications, including Word, Excel and Access
• Experience leading direct reports
Preferred Qualifications
• Bachelor's degree
• Strong claims/PPI experience
• Process improvement experience
Additional Information
This position is considered "remote/work at home", however, the ideal candidate will be located in the North/Central region of Florida or near the Louisville, KY Corporate office.
• 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
For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
If progressed to offer, you will be required to:
• Provide proof of full vaccination or commit to testing protocols OR
• Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state and remote-only work exemptions are available.
Scheduled Weekly Hours
40
Hiring Insights Job activity Posted 2 days ago