Sr Analyst Network Ops

Job DescriptionThis exciting role is a fast-paced healthcare provider support role, intended to foster a positive provider experience by responding to provider inquiries, performing provider demographic updates and data audits, as well asother provider initiatives.Required QualificationsThe Senior Analyst, Network Operations is a key role within the Network Operations function. The role is responsible for supporting Aetna's provider network by facilitating new provider applications, managing provider inquiries and assistance requests, and ensuring provider data and demographic information is maintained current. The role is a senior individual contributor position and part of a broader team of colleagues with similar responsibilities. The role will have a broader span of influence over responsible areas, and it will command larger production standards as compared to Network Relations Specialist colleagues. The role's ability to demonstrate independent judgement and authority while effectively operating in ambiguous situations will be a key factor for success. Key Responsibilities: Achieve specific production standards across provider onboarding applications, provider assistance inquiries, and provider data updates as defined by department management. Role focus will span entire continuum of support across the provider application / inquiry / data integrity processes Manage the provider application / onboarding process and workflow within internal systems, ensuring information is collected and documented against workflow standards. Although the role will be oriented to specific workflow supporting these tasks, independent judgment will commonly be required to resolve ambiguous provider requests and/or situations. Respond to provider inquiries (Network Assistance Form tickets) spanning several types of inquiries (ex: status of their application) Role will conduct necessary independent research/outreach/steps to resolve provider situations within specified turnaround times Research provider requests for demographic data maintenance to validate accuracy of change request and/or if more information may be needed. Interact with provider to close information gaps where necessary. Work with internal cross-functional partners to submit information updates into various provider data systems Ensure accuracy of our provider applications, inquiry responses, and all corresponding data by engaging in related review and audit processes Role will interact with external providers and must demonstrate appropriate professionalism and communication standardsCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- 3+ years' experience in Network or related business environment with exposure to provider systems, processes, etc. is required- Strong organizational skills with demonstrated ability to balance multiple concurrent priorities- Strong communication, critical thinking, problem resolution and interpersonal skills.- Working knowledge of business systems, applications, and tools.- Desktop Tool experience - Microsoft OfficeEducationBachelor's Degree or equivalent combination of educationand experience.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2024-10-19