Humana Research Consultant in Louisville, Kentucky
Role: *Research*Consultant *Assignment: *Claims Cost Management Research and Opportunity Team *Location: *Blankenbaker (Louisville, KY), Jacksonville, FL, Puerto Rico
Assignment Capsule As a Business Consultant in the Claims Cost Management department you will serve as a subject matter expert lead on special projects involving new opportunities for Humana, providing timely and accurate analysis, design and testing coordination, and documentation of complex business tasks and processes. You will also develop schedules and plans for the coordination and management of resources to establish more efficient business operations. You will work with multiple business areas to achieve the highest results and gain for the company.
· Successfully manage multiple projects simultaneously · Analyze trends in claims and financial recovery data to make process improvement recommendations · Proactively identify projects that can lead to administrative or financial savings · Communicate findings and recommendations to internal partners
Key Competencies _Customer Focus:_* Connects meaningfully with customers to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience. *_Collaborates:_ Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first. _Builds Trust:_* Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions. *_Executes for Results:_ Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints. _Acts Strategically:_ Makes decisions and sets strategy based on the long-term vision, uses an enterprise-wide perspective to translate strategies into actions, inspires others to embrace and advance the strategy, and creates a clear view of the future state.
Role Essentials · Experience in the health insurance industry, healthcare finance or healthcare related consulting · Proficient in Microsoft Access, Excel, and PowerPoint · Experience creating or auditing overpayment concepts (prepay or postpay) · Strong written communication skills · Experience analyzing and summarizing large data sets
Role Desirables · Bachelor’s Degree
· At least 2 years of Humana claims experience (CAS or MTV)
· CCM audit tools (EFR, MOAT) · Reporting design experience using relational databases, PL/SQL preferred
You will report to a Process Manager. This area is under the leadership of the SVP & Chief Operating Officer At Humana, we know your well-being is important to you, and it’s important to us too. That’s why we’re committed to making resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. If you share our passion for helping people, we likely have the right place for you at Humana.
Job Provider Network Operations
Title: Research Consultant
Other Locations: US-FL-Jacksonville, US-Puerto Rico-Hato Rey
Requisition ID: 175820