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Provider Network Analyst Sr

Company: Amerihealth
Location: Baton Rouge
Posted on: March 20, 2023

Job Description:

Job Description:

\nJob Brief\n Great opportunity for a health care provider operations analyst to join an established MCO in Louisiana. This is a remote position, and we will entertain candidates who reside outside Louisiana.\n\n\n\n\n\n Your career starts now. We're looking for the next generation of health care leaders.\n At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.\n Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at\n\n\n\n\n\n\n Responsibilities:\n Responsible for research and analysis related to provider network issues. Supports new business provider recruitment and contracting or responsible for research and analysis related to provider claims issues. Identifies systematic and procedural issues resulting in processing reports and initiating actions to produce reports. Extracts manipulates and evaluates accuracy of provider data for new implementations or responsible for ensuring plan stays in compliance with provider contracts.\n Gathers complex statistical data analysis to identify financial and non-financial impacts and process and system improvements. Uses provider contract maintenance software to create provider contract templates and creates files associating contract templates and other credentialing forms. Assists with and coordinates second level provider disputes and LDH provider complaints. \n Education/Experience:\n\nBachelor's Degree (i.e., Business) or an equivalent education and experience preferred.\nFacets claims processing system program experience required.\nClaims analysis experience and associated analytical skills required.\n1-2 years managed care or related experience.\n3-5 years analytical experience in the Healthcare industry.\nProficiency with Microsoft Office Suite (Word, Excel, Power Point). \nAbility to plan, organize and handle multiple tasks with limited supervision.\n \n\n\nBack\n\n\n\n\n\n\n\n\nApply Now\n\n

Keywords: Amerihealth, Baton Rouge , Provider Network Analyst Sr, Professions , Baton Rouge, Louisiana

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