Provider Network Operations

**Become a part of our caring community** Humana Healthy Horizons is looking for a Network Operations Professional who maintains provider relations to support customer service activities through data integrity management and gathering of provider claims data needed for service operations. The Network Operations Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Network Operations Professional responsibilities include (but not limited to): + Manage provider data for health plans including demographics, rates, and contract intent. + Manages provider audits, provider service and relations, credentialing, and contract management systems. + Execute processes for intake and manage provider perceived service failures. + Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. + Follow established guidelines/procedures. • *Use yo