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CareSource

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

LTSS Provider Network Operations Analyst II – Provider Relations, Managed Care Experience

Network OperationsNetwork OperationsOtherRemoteMid LevelTeam 1,001-5,000Since 30+ yearsH1B SponsorCompany SiteLinkedIn

Location

Ohio

Posted

121 days ago

Salary

$62.7K - $100.4K / year

Seniority

Mid Level

Bachelor Degree2 yrs expEnglish

Job Description

LTSS Provider Network Operations Analyst II – Provider Relations, Managed Care Experience

CareSource

• Analyze data, workloads, and processes to enhance operations efficiencies in support of LTSS & HCBS providers • Identify trends and solutions to operational support and ensure provider adherence to regulatory and contractual requirements • Perform quality assurance reviews to ensure that provider information is loaded correctly, and contracting terms are accurately operationalized • Improve Electronic Visit Verification compliance rates for provider network • Manage online communications and optimize service delivery and provider experience

Job Requirements

  • Bachelor of Science/Arts degree or equivalent years of relevant work experience is required
  • Minimum of three (2) years of business management or health care operations experience in insurance, managed care, or related industry is required
  • Minimum of two (2) years Provider Relations experience is required
  • Advanced knowledge of Medicaid, Medicare, MyCare, LTSS, HCBS, and Ohio Home Care Waiver is required
  • Proficient in Microsoft Office Suite to include Word, Excel and PowerPoint
  • Proven experience with project management tools and resolution of open issues
  • Ability to execute small to medium scope project plans including business requirements gathering, definition/prioritization, project scope definition, training, and documentation

Benefits

  • Influenza vaccination is a requirement of this position
  • CareSource provides reasonable accommodations to qualified individuals with disabilities
  • Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members

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