Senior Analyst, Network Relations

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Serves as the main point of contact for the designated area of integrated providers.

• Facilitates provider education, ensures adherence to contracts, manages provider communications, conducts claims research, and aids in resolution processes.

• Implements both internal and external solutions to enhance provider satisfaction, meet cost targets, promote network growth, and achieve efficiency objectives.

⛳️ Requirements

• 3-5 years of experience in provider relations and/or network management is required.

• Must possess expertise in all reimbursement payment methodologies.

• Experience working with large provider groups, capitated agreements, and behavioral health providers is essential.

• Exceptional written, verbal, and interpersonal communication skills are a must.

• Proficient in Word, Excel, and Microsoft Office.

• Must demonstrate flexibility and the ability to thrive in a highly dynamic, fast-paced environment.

• Knowledge of Medicare programs is important.

• Familiarity with various Behavioral Health and Commercial payment methodologies is required.

• Understanding of medical claims processing is necessary.

• Experience with Provider Databases (e.g., EPDB) is a plus.

• Strong critical thinking, problem-solving abilities, and capacity to work independently are essential.

• Excellent time management skills are required.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Comprehensive benefits package aimed at supporting the physical, emotional, and financial well-being of employees and their families.