Provider Data Management Professional

Become a part of our caring community and help us put health first

The Provider Business Intelligence teams are committed to effective and efficient business solutions for quality assurance and risk mitigation in implementing Humana's Provider Medicare/Medicaid contracts. We are in search of a Business Intelligence Engineer 1 to provide support to our Provider Facility and Physician accounts to ensure we are meeting contractual requirements and expected timelines for the respective contracts.



The Business Intelligence Engineer 1 provides support to provider or facility accounts by loading contracts, responding to inquiries and resolving issues of concern. This role performs set-up, database loading, and preparation of administrative documents/materials for Provider Facility or Physician accounts/contract loads. As a Business Intelligence Engineer you can expect to research, identify and correct contract loading errors to decrease claims payment issues. Facility or Physician arrangements and interpretations will be revised; followed by loading them into Humana systems.

As a Business Intelligence Engineer 1 you will communicate with all system users and market office staff regarding, but not limited to; inquiries, change in contracts and system status reports. A successful candidate will have high quality communication skills (written and verbal), top-notch organizational skills with attention to detail, and ability to maintain multiple competing priorities.

Use your skills to make an impact

Required Qualifications

1+ years of Provider Installation Experience (credentialing, contracts, provider database/directories, or related area)

1+ years experience in a metric/production driven environment

Prior professional experience using Microsoft Office Programs, including Word, Excel, PowerPoint

Must meet Humana's Work at Home connectivity requirements listed in additional information

Meet location requirements identified in additional information

Preferred Qualifications

Associates or Bachelors Degree

CAS, MTV, PAAG, or APEX systems experience

Claims experience

Provider data management data loading/analysis/review

Additional information

Hours: 7a-9am start time; OT based upon business need (can complete during work week/weekend) No PTO month of July due to Medicare-Push season

Training: 5 week virtual class room training

Location: Remote US

To maximize the investment in our talent and support associates success in achieving competency levels which enable associates to understand scope of process and make connections with other areas of the enterprise, the Provider Contract Team has a time-in-job commitment of 18 months.

Interview Format

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue 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.

Work at Home Statement

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership.

Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter by visiting go/Buzz and searching Ask A Recruiter or email *** . Please be sure to provide the requisition number so we may be able to research your request quicker.

This is a remote position
• PPNO

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$55,200 - $75,300 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 01-29-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***/legal/accessibility-resources?source=Humana_Website.