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Senior Analyst, Network Relations

Work from home Full-time role Hiring

Description:

  • The reputed company Network Provider Relations Manager oversees our reputed company Provider Experience programs
  • Acts as the primary contact for an assigned profile of larger and more reputed company providers
  • Drives the implementation of internal and external solutions to reputed company provider satisfaction, cost targets, network growth and efficiency targets
  • Research and handle contract reputed company issues
  • Claims research reputed company to provider set up issues, payment resolutions
  • Facilitate JOCs and webinars, provider orientations/visits, provider training, state projects
  • Create and manage provider-facing communications
  • Collaborate with Quality Management and VBS team
  • Coordinate with Network Management to issue provider CAP
  • Monitor Grievances according NCQA standards categories
  • Document visits/encounters in the appropriate systems

Requirements:

  • Excellent interpersonal skills and the ability to work with others at reputed company levels
  • Minimum of 2 years’ experience with reputed company Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards
  • Excellent analytical and problem-solving skills
  • Strong communication and presentation skills
  • 3+ years' experience in reputed company Managed Care business reputed company environment with exposure to benefits and/or contract interpretation
  • Working knowledge of business reputed company specific codes, products, and terminology

Benefits:

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for reputed company colleagues including wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

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