Join our dynamic team as a Business Analyst for Provider Network Operations, where you'll play a crucial role in migrating to a new core claim system. This position offers the opportunity to work cross-functionally and contribute to impactful projects in the healthcare sector.

Responsibilities

• Facilitate the migration to a new core claim system for the Provider Network Operations team.
• Participate in meetings throughout the phased rollout, including preparation, testing, and post-launch activities.
• Maintain and update issue trackers and process documents for leadership.
• Prepare executive summaries and communication materials to convey system changes.
• Represent leadership in operational meetings and assist in resolving project issues.
• Ensure provider data quality and monitor complaints related to system migration.
• Act as a liaison between departments to address project-related inquiries.

Skills

• Bachelor’s degree with 3-5 years of experience in a health plan environment.
• Strong understanding of provider network management and health system hierarchy.
• Knowledge of provider network contract terms and claims adjudication.
• Proficiency in data collection, analysis, and reporting.

Preferred Skills

• Experience with Health Edge/HRP systems.
• Familiarity with Salesforce in a health plan setting.
• Experience in Medicaid plans.

We are committed to fostering a diverse and inclusive workplace where all individuals are valued and respected. We encourage applications from candidates of all backgrounds and experiences.