Role Description

The Network Operations Coordinator 4 manages and maintains provider contract data and demographics for assigned provider groups for the Health Plan. Manages provider relationships through shared services that supports Provider Network Operations. This includes, but is not limited to:

• Performing Roster Audits
• Acting as a customer service liaison
• Resolving provider load issues
• Managing Projects as assigned

Makes decisions regarding own work methods and requires minimal direction. Uses critical thinking to solve problems, works independently with strong time management and organizational skills to complete required work. Follows established guidelines and procedures.

Qualifications

• Minimum of 2 years of experience working in a healthcare setting with providers, payors, healthcare facilities, etc.
• Data analytic experience
• Intermediate skills with Microsoft Office, and proficient in Excel
• Ability to multi-task and work in a deadline driven environment

Requirements

• Experience with APEX, PMDM, PAAG or CRM (Preferred)
• Provider contract interpretation experience (Preferred)
• Previous account management or project management (Preferred)
• Knowledge of medical claims (Preferred)

Work at Home Requirements: 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Medical, dental and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities

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.

$53,100 - $72,500 per year

Application Deadline

10-01-2026

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.