Central Region Healthcare Provider Network Lead Analyst

Central Region Healthcare Provider Network Lead Analyst

Requirements

• Bachelor’s degree, required; Master’s degree, highly preferred
• 5+ years Network Operations Contracting experience, required
• 5+ years’ experience working in the Healthcare industry, required
• Cigna systems experience, required
• Proficient in the use of PC software; i.e., Outlook, WebEx, One Note, Power Point
• Strong Microsoft excel skills required
• Strong Microsoft Access skills a plus
• Working knowledge of hospital, managed care and provider business models
• Understanding of market specific nuances and network constructs
• Strong project management, analytical and critical thinking skills
• Superior problem solving and decision making skills
• Strong interpersonal and written/oral communication skills
• Proven ability to interact and negotiate effectively with various matrix partners

Responsibilities

• Manage new hire and existing analyst training as needed (technical skills and workflows). This includes the creation and maintenance of department workflows and related training documentation.
• Identify proactive recruitment projects and manage review and approval of all incoming recruitment projects.
• Work closely with Network Access Lead to support/provide required analysis work to map out required recruitment efforts/strategy to replace Third Party Vendors (TPV) in specific geographies and/or Alliance Partner replacements as required.
• Manage and track approved TPV conversions and/or Alliance Partner replacement projects in the Northeast and Central regions.
• Cover for Network Access Lead while on PTO and attend meetings for manager as needed.
• For assigned markets, review recruit project datasets to identify recruitment universe; Review potential recruits against Cigna systems to check for current/previous par status, approved specialty recruitment in specific geographies and validate if the provider is currently in recruitment under a separate initiative.
• Manage the recruitment tracking tool: project data uploads and provider record maintenance for the duration of the project.
• Partner with Contracting and Sales/Service organizations to manage the review of providers identified as non-participating through the Regional Support Unit provide review process in support of pre-sale activities and current client non-par inquiries for assigned markets.
• Lead regional market research relating to competitor provider network participation status, competitor product development, regulatory developments and other market developments as appropriate for assigned markets.
• Lead Hospital/Large and/or Significant Provider Termination weekly workgroup meetings for assigned markets.
• Lead separate and/or additional termination management meetings as needed to discuss segment specific activities or non-standard termination tactics to support high visibility/challenging negotiations.
• Manage the creation and distribution of the weekly term management workgroup notes for assigned markets.
• Strive to become the subject matter expert (SME) for all assigned states and segments in your Region in support of all role activities; termination management, recruitment initiatives and competitive analysis.
• Work collaboratively with resources within the region, other regions and nationally to ensure projects are consistently managed, tracked and reported.
• Special projects as required.

Preferred Qualifications

• Strong Microsoft Access skills a plus