Senior Network Relations Analyst

Role Overview

• Acts as the primary liaison for assigned geography of integrated providers, (i.e. market/regional/national, large group) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities.
• Conducts provider education, ensures contract compliance, provider communication, claims research and assists with resolution.
• Implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.

Requirements

• 3-5 years of provider relations and/or network management experience required
• Experienced in working with large provider groups, capitated agreements, behavioral health provider
• Must have excellent written, oral, and interpersonal communication skills
• Computer literate in Word, Excel, Microsoft Office
• Must be flexible and able to handle a highly, fast-paced environment
• Knowledge of Medicare programs
• Knowledge of various Behavioral Health and Commercial payment methodologies
• Medical claims processing knowledge
• Experience working within Provider Databases (i.e. EPDB) a plus
• Critical thinking, problem resolution and ability to work independently
• Excellent time management skills

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility