Description
We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.
The Senior Analyst, Behavioral Health Network is responsible for supporting the development, maintenance, and optimization of the Behavioral Health provider network, with a primary focus on Applied Behavior Analysis (ABA) providers and related autism services.
Job Duties Include:
Network Development & Provider Relations
- Support recruitment, onboarding, and retention of ABA and behavioral health providers to meet network adequacy and accessibility goals.
- Serve as a primary point of contact for provider organizations and practitioners regarding network participation, operational concerns, and escalated service issues.
- Build and maintain strong provider relationships to support engagement and network stability.
Network Analysis & Reporting
- Analyze provider network data to identify trends, gaps in coverage, capacity constraints, and opportunities for network expansion.
- Monitor network adequacy standards and access-to-care metrics to ensure compliance with regulatory and business requirements.
- Develop and present reports, dashboards, and recommendations using tools such as Excel, Power BI, and other reporting platforms.
- Assess provider utilization, performance, and participation patterns to support strategic decision-making.
Provider Operations Support
- Investigate and resolve provider inquiries related to credentialing, demographic maintenance, and network participation.
- Partner with operations teams to address provider data accuracy and resolve system or operational issues impacting providers.
- Coordinate provider demographic updates and ensure accurate provider information across all systems and directories.
- Support implementation of new processes, programs, and operational enhancements affecting provider networks.
Contracting & Credentialing Support
- Collaborate with contracting teams to facilitate provider recruitment efforts, contract execution, amendments, and renewals.
- Support credentialing and recredentialing activities to ensure providers meet organizational and regulatory standards.
- Track provider onboarding activities and monitor completion of required documentation.
Business Analysis & Process Improvement
- Gather, analyze, and document business requirements related to provider network management initiatives.
- Evaluate current-state workflows and identify opportunities to improve efficiency, provider experience, and operational performance.
- Participate in cross-functional projects supporting behavioral health growth initiatives and network transformation efforts.
- Recommend process enhancements and system improvements that improve provider and member outcomes.
Regulatory Compliance & Quality Support
- Ensure provider network activities align with state, federal, accreditation, and organizational requirements.
- Support audits, regulatory requests, and network reporting obligations.
- Assist with quality improvement initiatives designed to improve provider performance, network effectiveness, and member access to care.
Required Qualifications:
- 3-5 years of experience in healthcare network management, provider relations, provider operations, behavioral health administration, or related healthcare roles.
- Experience working with provider networks, credentialing, contracting, claims, or provider service operations.
- Strong analytical and problem-solving skills with the ability to interpret data and identify actionable insights.
- Experience managing multiple priorities and collaborating across a matrixed organization.
- Excellent verbal and written communication skills, including the ability to present data-driven insights to leadership.
- Proficiency in Microsoft Office applications, particularly Excel, and Power BI.
- Exceptional organizational skills and attention to detail.
Benefits:
- Medical, dental, and vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs.
Salary Range: $46,988.00 - $112,200.00