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Gravie

Senior Provider Network Operations Analyst

RemoteNot specified
Published
Role
Operations
Experience
Senior
Employment
Full-time
Company size
Startup
$67.6k–$90.1k/yr
Check eligibility

The listing doesn't say where it hires from. Check the description or the employer's site before applying.

No BS summary

Seeking a Senior Provider Network Operations Analyst with 2+ years of experience in healthcare/health plan operations, process improvement, and data analysis. Must have a Bachelor's degree or equivalent experience and a proven ability to manage provider networks and build reporting. Experience with SQL, Excel, or BI tools is a plus.

Core skills

provider network operationsprocess improvementdata analysis

Required skills

network operationshealth plan operationsprovider network managementoperational processesprovider datanetwork datareporting

Optional skills

SQLExcelTableauLookerPower BInetwork adequacy requirementsCMS reporting standardsstate reporting standards

What you'll do

  • Manage the day-to-day operations of Gravie's existing provider networks, staying on top of open issues, renewals, and anything that needs attention
  • Document network operations processes and keep them current as workflows evolve
  • Administer the provider network inquiry intake system day to day — apply triage rules and prioritization criteria, monitor SLAs and queue aging, and report on volume and resolution trends across all channels
  • Build and maintain network scorecards that give the team a simple, reliable view of how the network is performing
  • Dig into deviations or inconsistencies in provider reporting, run them down to root cause, and recommend process fixes to Network leadership
  • Turn network data into practical insights that the Network leadership team can use to make decisions
  • Partner with Contracting, Customer Service, Claims and our Networks to close gaps in how provider data flows between teams and systems
  • Identify where manual, ad hoc work can be replaced with a repeatable process, checklist, or lightweight tool
  • Act as a key operational partner to Provider Network leadership, flagging risks and recommending fixes before they become bigger issues

What they require

  • Bachelor's degree, or equivalent experience, and 2+ years of experience in network operations, health plan operations, or provider network management
  • 2+ years of experience building or improving operational processes in a healthcare or health plan setting
  • 2+ years of experience managing the ongoing performance of a provider network or similar operational function
  • 2+ years of experience working with provider, claims, or network data to build reporting or track performance

Benefits

  • standard health and wellness benefits
  • alternative medicine coverage
  • flexible PTO
  • up to 16 weeks paid parental leave
  • paid holidays
  • a 401k program
  • transportation perks
  • education reimbursement
  • 2 days of paid paw-ternity leave

Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

HealthcareStartup
$67.6k–$90.1k/yr