Job Description:
• Act as liaison between vendors and the organization
• Review and negotiate vendor contract terms
• Communicate with vendors regarding daily matters
• Develop positive vendor relationships
• Monitor vendor performance
• Research invoice and contractual issues
• Resolve discrepancies
• Influence department strategy
• Make decisions regarding technical approaches for project components
• Perform work independently without direction
• Determine goals and approaches to assignments
• Travel occasionally to Humana offices for training or meetings
Requirements:
• Progressive operational experience
• Leadership experience over a large metric-intensive operational unit
• Facilitation skills
• Passion for contributing to an organization focused on improving consumer experiences
• Six Sigma or Project Management Institute certification preferred
• Prior healthcare or insurance experience preferred
• Knowledge of Medicare Advantage preferred
• Grievance and Appeals experience preferred
• 3 or more years of pharmacy claims processing experience preferred
• Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information
• Self-provided internet with minimum download speed of 25 Mbps and upload speed of 10 Mbps
• Ability to travel occasionally to Humana offices for training or meetings
Benefits:
• Bonus incentive plan based on company and/or individual performance
• Medical benefits
• Dental benefits
• Vision benefits
• 401(k) retirement savings plan
• Paid time off
• Company holidays
• Personal holidays
• Paid parental leave
• Paid caregiver leave
• Short-term disability
• Long-term disability
• Life insurance
• Personal wellness and healthcare decision support benefits