Senior Network Operations Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the daily operations of Gravie's current provider networks, addressing ongoing issues and renewals.

• Document the processes involved in network operations and ensure they remain up to date as workflows change.

• Manage the provider network inquiry intake system utilizing triage and prioritization guidelines.

• Track SLAs and queue aging while reporting on volume and resolution trends across various channels.

• Create and sustain network scorecards.

• Examine discrepancies and inconsistencies in provider reporting, determine root causes, and propose process improvements.

• Transform network data into actionable insights for decision-making by Network leadership.

• Collaborate with Contracting, Customer Service, Claims, and Networks to enhance provider data flows among teams and systems.

• Replace manual, ad hoc tasks with standardized processes, checklists, or simple tools.

• Identify operational risks and suggest remedies to Provider Network leadership.

⛳️ Requirements

• Bachelor's degree or equivalent experience.

• A minimum of 2 years' experience in network operations, health plan operations, or provider network management.

• At least 2 years of experience in developing or refining operational processes within a healthcare or health plan environment.

• 2+ years of experience overseeing the ongoing performance of a provider network or a similar operational role.

• 2+ years of experience working with provider, claims, or network data to develop reports or monitor performance.

• Knowledge of network adequacy requirements or CMS/state reporting standards.

• Proficiency in SQL, Excel, or Business Intelligence tools such as Tableau, Looker, or Power BI.

• Experience in project or program management.

🏝️ Benefits

• Coverage for alternative medicine.

• Flexible paid time off (PTO).

• Up to 16 weeks of paid parental leave.

• Paid holidays.

• 401k retirement program.

• Transportation benefits.

• Education reimbursement.

• 2 days of paid paw-ternity leave.

• Standard health and wellness benefits.