Senior Network Operations Analyst, Provider Compliance

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

📋 Description

• Assist in the daily support and preparation involved in the provider termination process.

• Gather and report termination data across various groups.

• Aid in investigations related to pharmacy noncompliance.

• Provide collaborative assistance for requests from the Client Account Team that intersect with pharmacy operations and compliance.

• Ensure that network providers adhere to state and federal regulations, the ESI Provider Manual, and the Provider Agreement.

• Act as a liaison for internal inquiries and projects related to compliance.

• Identify and synchronize business process efficiencies among teams and cross-functional partners.

• Propel process enhancements, automation, technology adoption, and cross-functional collaborations.

• Achieve operational excellence while managing multiple competing priorities.

⛳️ Requirements

• A bachelor’s degree in a related field is preferred.

• A high school diploma is required.

• A minimum of 2 years of relevant work experience.

• Proficiency in the Microsoft Office suite, including Word, Excel, PowerPoint, and Outlook.

• Strong written and verbal communication abilities.

• Exceptional attention to detail, follow-through, and capability to manage multiple tasks while meeting daily deadlines.

• Capacity to exhibit initiative and independent thinking.

• Ability to adopt a strategic mindset while addressing tactical challenges.

• Proven capability to collaborate with cross-functional departments to resolve issues.

• Strong analytical and problem-solving expertise.

• Ability to adapt to a dynamic, fast-paced work environment and make independent decisions.

• A cable broadband or fiber optic internet connection with a minimum of 10 Mbps download and 5 Mbps upload speed for remote work.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical benefits commencing on day one.

• Vision benefits available starting day one.

• Dental benefits beginning on day one.

• Well-being and behavioral health programs available from day one.

• 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Leaves of absence.

• Work-from-home arrangement.