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The Provider Activation 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, respond to inquiries and resolves 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.
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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 professional experience utilizing one or more of the following:
Healthcare/Provider Knowledge
Medical Terminology
Health Insurance knowledge
- 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
Preferred Qualifications
- Associates or Bachelor's Degree
- CAS, MTV, PAAG, or APEX systems experience
- Claims experience
Additional information
Hours: 6am-9am start time; OT based upon business need (can complete during work week/weekend) Limited PTO month of July due to Medicare-Push season
Location: Remote IN, KY, WI, OH, or MI. Must be within 2 hours commutable distance of a Humana office.
Training: 5 week virtual class room training
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.
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
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 recommended; 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
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.
$53,700 - $74,100 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.
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 because he or she is a protected veteran. 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.