[Work From Home] Senior Analyst, Network Relations

Key Job Details:

• Location: Remote
• Compensation: a competitive salary
• Company: Workwarp
• Position: Senior Analyst, Network Relations
• Start Date: Immediate openings available

 

 

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary Oversees our Medicaid Provider Experience programs to reputed company and maintain provider risk management and positive relationships supporting high value initiatives with our Network Providers. This role acts as the primary contact for an assigned profile of larger and more reputed company providers (i.e., market/ regional/ national, large group or hospital systems). Drives the implementation of internal and external solutions to reputed company provider satisfaction, cost targets, network growth, and efficiency targets. Duties: Research and handle contract reputed company issues (ability to research and deep dive). Claims research reputed company to provider set up issues, payment resolutions and coordinate with Claims SME Provider visits onsite, virtual, and telephonic Facilitate JOCs and webinars. Provider orientations/visits Provider training State projects Create and manage provider-facing communications: newsletters, website updates, provider manual, email/fax blast. Collaborate with Quality Management and VBS team to assist with facilitation of provider request to enhance quality metrics and relationship building. Coordinate with Network Management to issue provider CAP Monitor Grievances according NCQA standards categories (3 grievances per QTR), including progressive corrective action. Monitor provider performance in accordance with provider responsibilities policy, contract, state, and federal requirements. Attend Plan committee meetings, as needed. Recredentialing non-responder follow up. Communicate growth partner response to providers. Manage IPA provider rosters, submit to MPOS. Document visits/encounters in the appropriate systems (CRM) Other duties as assigned. Required Qualifications • Excellent interpersonal skills and the ability to work with others at reputed company 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 reputed company environment with exposure to benefits and/or contract interpretation • Working knowledge of business reputed company specific codes, products, and terminology Preferred Qualifications • Candidates are to reside reputed company Illinois with ability to travel as needed to provider sites and reputed company office locations as required • Previous MCO experience working with the Medicaid line of business Education Bachelor's degree preferred/specialized training/relevant professional qualification Pay Range The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 02/27/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply Job!

 

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