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The Network Optimization Lead, under the guidance of the Network Optimization Director, is responsible for financial and productivity analytics in support of day-to-day operations, performance, and business strategy for the TRICARE optimization product lines encompassing both clinical and network enhancement. Primary responsibilities include sourcing, modeling, and analyzing data for the optimization production lines to identify and explain variance and outcomes. Support and execute data capture and processing for clinical workload. Support and facilitate financial operations related to procurements, as well as vendor and contractor receivables and payables. Responsible for data management including maintaining and collecting structured and unstructured data managing data. Support assessment of financial and operational impacts for optimization programs. Support technology development and algorithms. Prepare and advise on performance reporting and metrics. Participate in consultation and program development with government customers, external partners, and internal associates from finance, contracting, legal, information technology, market operations, network development, provider administration.

KEY ACCOUNTABILITIES

+ Assure systems and processes are designed to capture required productivity data and report in accordance with government requirements.Utilize financial, statistical, and technology tools to transform complex data to identify operational improvement opportunities and solutions.Conduct and support audits/reviews as needed.Analyze healthcare, productivity, and financial data, identify anomalies and discrepancies, develop and implement corrective actions as necessary.

+ Assimilate market models from structured and unstructured data sets. Evaluates and refines analytical methodologies, and algorithms. Responsible for ensuring compliance with government regulations and alignment to specifications. Collaborate with technical and finance teams.

+ Support operational planning, forecasting, and optimization activities.Support and manage payments, and receivables related to health care services procurement, contracts, and vendor agreements.

+ Collaborate and advise on best practices, tool maximization, and integration of a cloud-based fulfillment and workflow management system.Develop, and maintain operational reports, financial reports, and performance metrics.Implement and execute quality assurance processes and educate with internal and external customers on issues and resolutions.

+ Assure all components of the product development and fulfillment lifecycle are collected, captured, and reported in accordance with operational needs and government requirements.Coordinate with internal teams to manage changes, identify, and resolve discrepancies.

+ Assess and implement change orders, funding changes, deobligations, and related impacts to operations and pricing. Provide guidance and support for strategic business development efforts, special projects, demonstrations/pilots, and incentive maximization. Collaborate with external government personnel and internal teams.

Use your skills to make an impact

Required Qualifications

+ Our Department of Defense Contract requires U.S. citizenship for this position

+ Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)

+ HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.

+ Bachelor's Degree in Accounting or Finance

+ 3 years of experience working in accounting/finance field for the Military, government contractor and/or Government handling financial modeling

+ Strong Excel skills, including pivot tables and formulas

+ Knowledge of Healthcare, Provider Contracting, and/or TRICARE program

Preferred Qualifications

+ Experience with TRICARE, to include MTF and/or Defense Health Agency

+ Experience reviewing and analyzing healthcare and financial data

Work at Home Requirements

To ensure Hybrid Office/Home associates’ ability to work effectively, the self-provided internet service of Hybrid Office/Home associates 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

+ 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

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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.

$115,200 - $158,400 per year

This 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.

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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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.