Associate Director - Network Adequacy - Humana
Providence, RI
About the Job
Become a part of our caring community and help us put health first
The Associate Director, Network Adequacy tests the overall network in each county of operations to ensure the network is strong enough to support serving customers. The Associate Director, Network Adequacy generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Associate Director, Network Adequacy requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Network Adequacy integrates data from multiple sources to produce requested or required data elements. Programs and maintains report forms and formats, information dashboards, data generators, canned reports and other end-user information portals or resources. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
+ Health benefits effective day 1
+ Paid time off, holidays, volunteer time and jury duty pay
+ Recognition pay
+ 401(k) retirement savings plan with employer match
+ Tuition assistance
+ Scholarships for eligible dependents
+ Parental and caregiver leave
+ Employee charity matching program
+ Network Resource Groups (NRGs)
+ Career development opportunities
Use your skills to make an impact
Required Qualifications
+ 5 or more years of business and operational experience within managed care
+ Strong data analysis skills
+ Advanced in SQL, SAS and other data systems; ability to apply a wide variety of analytics processes dependent on business need
+ 2 or more years experience managing a team
+ Demonstrated strength in troubleshooting complex infrastructure incidents and problems
+ Experience implementing, integrating, and managing public and private cloud platforms (i.e. Quest Enterprise Services)
+ Ability to give direction, lead and influence through ambiguity and make sound business decisions
Preferred Qualifications
+ Advanced certifications in software and/or process improvement
+ Experience with Medicaid
+ Experience in provider networks/provider operations
+ Advanced degree
Additional Information
This role is considered "remote/work at home" and can be based anywhere in the United States with the preferred candidate being located within the Eastern Time Zone.
Work at Home Information
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
#LI-Remote
#LI-JR1
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.$102,200 - $140,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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.
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.
The Associate Director, Network Adequacy tests the overall network in each county of operations to ensure the network is strong enough to support serving customers. The Associate Director, Network Adequacy generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The Associate Director, Network Adequacy requires a solid understanding of how organization capabilities interrelate across department(s).
The Associate Director, Network Adequacy integrates data from multiple sources to produce requested or required data elements. Programs and maintains report forms and formats, information dashboards, data generators, canned reports and other end-user information portals or resources. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates.
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including:
+ Health benefits effective day 1
+ Paid time off, holidays, volunteer time and jury duty pay
+ Recognition pay
+ 401(k) retirement savings plan with employer match
+ Tuition assistance
+ Scholarships for eligible dependents
+ Parental and caregiver leave
+ Employee charity matching program
+ Network Resource Groups (NRGs)
+ Career development opportunities
Use your skills to make an impact
Required Qualifications
+ 5 or more years of business and operational experience within managed care
+ Strong data analysis skills
+ Advanced in SQL, SAS and other data systems; ability to apply a wide variety of analytics processes dependent on business need
+ 2 or more years experience managing a team
+ Demonstrated strength in troubleshooting complex infrastructure incidents and problems
+ Experience implementing, integrating, and managing public and private cloud platforms (i.e. Quest Enterprise Services)
+ Ability to give direction, lead and influence through ambiguity and make sound business decisions
Preferred Qualifications
+ Advanced certifications in software and/or process improvement
+ Experience with Medicaid
+ Experience in provider networks/provider operations
+ Advanced degree
Additional Information
This role is considered "remote/work at home" and can be based anywhere in the United States with the preferred candidate being located within the Eastern Time Zone.
Work at Home Information
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
#LI-Remote
#LI-JR1
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.$102,200 - $140,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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.
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.
Source : Humana