Role: Provider Network Operations Business Consultant Assignment: Provider Network Operations Location: Work at home anywhere
Healthcare isn’t just about health anymore. It’s about caring for family, friends, finances, and personal life goals. It’s about living life fully. At Humana, we want to help people everywhere, including our associates, lead their best lives. We support our associates to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our associates fresh perspective, new insights, and exciting opportunities to grow their careers. At Humana, we’re seeking innovative people who want to make positive changes in their lives, the lives of our members, and the healthcare industry as a whole.
Assignment Capsule As a Provider Network Operations Business Consultant you will: serve as a subject matter expert lead on special projects, providing timely and accurate analysis, design and testing coordination, and documentation of complex business tasks and processes. You will also develop schedules and plans for the coordination and management of resources to establish more efficient business operations. In this role will: * Consult with other business areas to create cost benefit analyses and prioritize current projects
Collect, analyze and communicate competitive intelligence to influence network development strategies
Support technical analysis by maintaining databases of network cost and competitive intelligence data and developing data extracts for routine and special studies
Prepare and present recommendations to both internal and external audiences
Resolve general issues and defects within Infra (Humana's Service Operations Issue Tracking system)
Bachelor’s degree in Business, Economics, Finance or related fields or equivalent work experience
Consultative skills which include ability to assess, understand the client and make recommendations
Excellent documentation skills
Ability to handle multiple tasks and deadlines
Self-starter; ability to work independently
Progressive experience in the health service industry, healthcare finance or healthcare related consulting
Experience managing projects
Ability to learn and understand new systems – technologically savvy
Prior experience in data management, data extraction and data reporting
Strong experience with Excel, PowerPoint and Word Role Desirables
Claims Analysis experience
Comprehensive knowledge of relational databases and programming SQL
Experience with healthcare information technology, actuarial science and/or provider contracting
Knowledge and experience in Six Sigma Methodology or other Process Improvement Tools
Reporting Relationships You will report to a PNO Manager.
Additional Information At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on what’s happening around our organization in the changing world of healthcare.
Title: Provider Network Operations Business Consultant
Other Locations: US-Texas-San Antonio, US-IN-Indianapolis, US-WI-Green Bay
Requisition ID: 181110
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We also provide free language interpreter services. See our full accessibility rights information and language options.