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Provider Contracting Analyst

  • Location

    Bedford, United States

  • Sector:

    Other Area(s)

  • Job type:

    Contract

  • Contact:

    Leric Arcigal

  • Job ref:

    21695

  • Published:

    about 1 year ago

  • Expiry date:

    2020-10-21

SUMMARY:

Primarily responsible for network adequacy requirements for all STAR+PLUS and MMP networks in Texas.

Coverage Area - STAR+PLUS Service Delivery Areas (Hidalgo, Tarrant and Northeast MRSA); MMP Network (Hidalgo County) Car and valid drivers license required (mileage reimbursement provided) May require 0-25% travel to network providers (regional)

RESPONSIBILITIES:

Maintain an adequate network according to compliance requirements.

Research and resolve network adequacy fails. This includes researching internal data errors that may be causing fails and locating recruitment opportunities and working closely with Contractor Sr. Analyst to get that provider in network.

Responsible for writing and updating all exceptions (both HHSC & TDI).

Provides support to Contracting Sr. Analyst as related to network needs including provider outreach.

Builds and maintains relationships that nurture provider partnerships to support the market strategy.

Initiates and maintains effective channels of communication with matrix partners.

Drives network strategy by analyzing internal reports.

Manages internal/external relationships through understanding the interrelationships as well as the competitive landscape.

Other duties as assigned.