*Role: *Business Consultant
*Assignment: *Medical Economics Division
*Location: *Doral, FL
At CarePlus we are more than just a brand, we are a team of associates that strive to give our members what they need to stay happy and healthy. 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 CarePlus, 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.
Utilize your business knowledge to help analyze and improve existing processes and procedures.
Humana is seeking a Business Consultant for Service Operations who will: lead and educate associates to help optimize service and operational metrics, evaluating existing issue resolution processes, applications and tools, and collaborating with multiple departments to continuously strive for excellence. * Partner with operations, subject matter experts, training, workforce management and call quality teams to develop and deploy continuous improvement initiatives across service centers * Evaluate and ensure the adequate performance of key associates in the Finance, Information Systems and Custom Contracts departments * Initiate and facilitate meetings with sales managers and client representatives to identify and document pertinent group trends * Cultivate relationships with the client, sales office personnel, agents, brokers and consultants throughout the implementation process
Role Essentials · Bachelor’s degree or 5 years minimum experience with analytical reporting · Minimum of Two (2) years work experience in healthcare analytics/data modeling in a health plan setting · Strong analytical and critical thinking skills · Intermediate level experience with Microsoft Excel and Access · Experience summarizing data and creating executive summaries with analysis · Experience presenting analytics to provider partners · Ability to handle multiple tasks and deadlines with attention to detail · Excellent communication skills
Role Desirables · Operational understanding of provider networks and capitation agreements · Experience with Microsoft SQL reporting and relational databases · Experience with pricing specialty care and ancillary lines · Claim processing and audit experience · Medical coding experience · Experience in Epidemiology
Reporting Relationships * You will report to a department manager.
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Montage Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence(please be sure to check your spam or junk folders often to ensure communication isn’t missed)inviting you to participate in a Montage Voice interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
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.
Please be advised, the role opportunity displayed here is for CarePlus - a wholly owned subsidiary of Humana Inc.
Title: Business Consultant / Medical Economics Division-Doral, FL
Requisition ID: 190015
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.