Senior Analyst, Network Relations

Description: • The Medicaid Network Provider Relations Manager oversees our Medicaid Provider Experience programs • Acts as the primary contact for an assigned profile of larger and more complex providers • Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth and efficiency targets • Research and handle contract related issues • Claims research related 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 all levels • Minimum of 2 years’ experience with Medicaid 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 Medicaid Managed Care business segment environment with exposure to benefits and/or contract interpretation • Working knowledge of business segment 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 all 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 Apply Job!