Network Operations Coordinator 4

Humana Inc; Dover (DE); Remote; USD 53,000 - 73,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement plan

Paid time off

Job summary

Humana Inc. in Delaware is seeking a Network Operations Coordinator 4 to manage provider contract data and demographics for assigned provider groups within the Health Plan.

You will support Provider Network Operations by performing roster audits, acting as a customer service liaison, resolving provider load issues, and coordinating projects as assigned. This role emphasizes independent work, strong time management, and problem solving with minimal direction.

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

Responsibilities

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

Skills

Data analytics

Microsoft Office

Excel

Healthcare setting

Tools

APEX

PMDM

CRM

Job description

Become a part of our caring community

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.

Use your skills to make an impact

Required 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

Preferred Qualifications

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

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.

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.

$53,100 - $72,500 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 10-01-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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. 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 https://www.humana.com/legal/accessibility-resources?source=Humana_Website.