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Sr Provider Installation Professional - Remote Nationwide

Humana Inc. Remote
remote data senior sql team loading coordination pcp capitation payments operations legal legal terminology
May 9, 2022
Humana Inc.
Brentwood, TN
FULL_TIME
DescriptionResponsibilitiesAs part of the Service Fund Specialty Load Team, the Senior Provider Installation Professional will work directly with our national and market contracting teams to influence specialist contract terms that align with Service Fund capabilities and contracting goals.Will identify, devise, or modify processes to support complex contractual agreements.Will be accountable for loading national and market specific contracts, including initial associations.Will work in close coordination with PCP Contract Load, Capitation Rates, Payments, and Balance Adjustments teams to ensure accurate contract implementation.Required QualificationsMinimum 1 year experience in Service Fund Operations to includeprovider contract interpretation, legal terminology, and/or Provider Value Based financial analysisExperience in data management, data extraction, and data reportingComprehensive knowledge of MS Office desktop applications (Word, Excel, PowerPoint)Excellent oral and written communication skillsExperience managing projects in a deadline driven areaMust be passionate about contributing to an organization focused on continuously improving consumer experiencesIf progressed to offer, you will be required to:Provide proof of full vaccination ORCommit to weekly testing, following all CDC protocols, ORProvide documentation for a medical or religious exemption considerationPreferred QualificationsBachelor's or advanced degreeExperience utilizing SQL to pull and review data elementsExtensive knowledge of multiple types of coding systems (CPT, HCPCS, ICD-10, Humana internal code sets)Comprehensive knowledge of relational databases and programming with SQL and/or Visual BasicExperience with healthcare information technology and actuarial scienceExperience working with Senior Leaders and influencing strategic decisionsWork-At-Home RequirementsWAH 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 informationScheduled Weekly Hours40

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