Network Operations Manager

Profile

Description

The Manager, Network Operations is a dynamic people leader within a blended Provider Development and Provider Engagement organization. Inclusive, and collaborative by nature. The Manager is an expert in the detailed tasks of provider load and maintenance, yet equally skilled at framing complex issues in a clear and concise way, offering solutions and building consensus to achieve goals.

Responsibilities

The Manager, Network Operations will lead a team of Network Operations Coordinators supporting the Dallas, Fort Worth and East Texas markets.

Accountable to process development, consistency and quality of network operations for a thriving network of over 22,000 providers and 25 value-based relationships.

Operational lead for processes related to load providers within Humana systems to ensure accuracy of directory information, value based panels and claims payment.

Creates end to end audit processes with published results

Provides leadership to ensure related network operations are performed at a high standard, including but not limited to credentialing tasks, contract load, tasks related to network adequacy.

Establishes expectations and maintains best in class provider experience.

Collaborates with regional Network and Provider Engagement teams.

The Manager will be skilled at evaluating fluctuations in workload and align resources to accomplish established goals, set priorities and support overall work life balance.

The Manager will have a demonstrated background in network operations functions and workflow metrics.

Works cross functionally to develop enterprise-minded solutions

Thinks creatively and brings new ideas to established processes

Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area.

Represents Network Operations within regional and corporate forums and conference calls.

Required Qualifications

Bachelor's Degree

6 or more years of experience with Providers and Analytics

Strong Excel Skills

Strong Network Operations acumen with proficiency in process, project management and auditing.

Demonstrated understanding of Network Operations metrics and the ability to assimilate data from multiple reporting systems into actionable dashboards.

Above average communication and presentation skills.

Must be passionate about contributing to an organization focused on continuously improving the provider experience.

Preferred Qualifications

Management experience

Master's Degree in Business Administration or Finance

Experience with ACO/Risk Contracting

Additional Information

This role can be located in either Humana's Dallas office or WAH within the East Texas region.

Work at Home/Remote Requirements Must ensure designated work area is free from distractions during work hours and virtual meetings Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com