Value Based Programs Analyst Job at Humana

Humana Louisville, KY 40202

The Value-Based Programs Analyst supports successful value-based provider relationships in the Service Fund Department with a focus on improving the provider experience and achieving path-to-value goals.

Responsibilities

The Value-Based Programs Analyst will be tasked with supporting various post-enrollment processes that connect members to the appropriate member-requested provider in our systems to support positive provider experience and improved relationships. The work will require understanding the type of request and corrective action needed, researching roadblocks for member-to-PCP relationships, how they impact provider data and payments, responding to inquiries, and providing general customer support (internally and externally). They will meet quality standards, but have some latitude over prioritization and timing of work.

  • Assists with various post-enrollment processes that ensure an accurate member-to-PCP relationship is maintained in Humana’s source systems
  • Understands the types of requests and corrective action needed, and address through implementing appropriate policies and procedures
  • Responds to customer inquiries for assistance or explanation of processes and policies
  • Researches roadblocks as needed to fulfill requests independently
  • Supports a positive customer experience and improved relationships
  • Regularly reports on how processes assist or hinder optional job performance function and provide feedback on opportunities to improve
  • Offers cross-functional collaboration with other teams or processes to support strategy objectives

Skills needed for this position:

  • Customer Relationship Management (CRM)
  • Process Management
  • Provider Management
  • Relationship Management

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:

  • Medical Benefits
  • Dental Benefits
  • Vision Benefits
  • Health Savings Accounts
  • Flex Spending Accounts
  • Life Insurance
  • 401(k)
  • PTO including 8 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
  • And more

Required Qualifications

  • 2+ years' customer service experience
  • Knowledge of Microsoft Office Programs Word and Excel
  • Excellent written and verbal communication skills
  • Ability to manage competing priorities in a fast-paced environment
  • Strong attention to detail


Preferred Qualifications

  • Knowledge of Microsoft Office Programs PowerPoint and SQL
  • Provider installation experience
  • Service Fund knowledge
  • Functional knowledge of one or more of the following: Service Fund, APEX, PIMS, PAAG, PMDM, CRM
  • PPNO experience

Additional Information

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Work at Home/Remote Requirements

Work-At-Home Requirements

  • To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
    • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
    • Wireless, Wired Cable or DSL connection is suggested.
    • Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
    • Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates 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 associates 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

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

Alert: 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.

#LI-LM1

Scheduled Weekly Hours

40

Not Specified
0


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