Lancaster, SC, United States
Editing, Writing, Healthcare
Oct 22, 2021
Senior Contract Tools, Education, Processes Professional - Remote
The Senior Contract Tools, Education, Processes Professional builds templates, standard documentation, policy and protocol, case studies, and disseminating best in class knowledge. The Senior Contract Tools, Education, Processes Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
The Senior, Contract Tools, Education and Processes Professional for Medicaid Network Implementation is responsible for ensuring the full range of network requirements for the Network Expansion and Optimization division of National Network Operations. The Senior Professional provides internal support to Provider Network by following through all tasks related to provider operations. Functions include but are not limited to helping facilitate the business development team, coordinates with the markets and provider service organization to ensure that the network is fully implemented within the RFP and state provider network requirements.
Reviews state Medicaid RFP for special network requirements that may have an impact to Humana's standard Policies and Procedures, Provider Manual and other National Network Operations impacts.
Coordinates with internal business partners and the technology team to ensure that Humana's contract(s) requirements are properly managed and published for the market use.
Oversees the project plan related to business owner tasks related to provider training, provider manual creation, assists and ensure any state specific policy is created.
Oversees National Network Operations (NNO) accountability matrix to ensure planning and management of post-implementation commitments.
Ensures deliverables are met within the timelines and requirements.
Collaborates with the Medicaid MSO team to ensure project success.
Completes other special projects and duties as requested.
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
Health Savings Accounts
Flex Spending Accounts
PTO including 7 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
Bachelor's Degree in Business, Healthcare Administration, Mathematics and/or related field
5 years of provider network implementation technical experience
Healthcare and/or managed care experience
Ability to handle mid scale projects and/or project management experience
Solid experience of interpretation and independent determination of the appropriate courses of action during projects
Possesses a solid understanding of how organization capabilities interrelate across department(s)
Clear oral and written communication skills
Flexible, dynamic personality who works well in a team environment
Master's degree in Business and/or related field
Understanding of legislative and/or legal regulation industry
Experience writing and editing policies and procedures
Experience reviewing provider manuals
We will requireâ€¯full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are aâ€¯healthcareâ€¯company committed to putting health and safety first for our members, patients, associates and the communities we serve.
If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.
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 is required.
Our Hiring Process
As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome
Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.
Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.
Scheduled Weekly Hours
Website : http://www.humana.com