CareAllies Network Operations Senior Analyst: Houston, Texas - Hybrid - Cigna Healthcare

About the position

The Network Operations Senior Analyst position at CareAllies is a pivotal role within the organization, primarily focused on enhancing provider relationships and optimizing network performance. This position serves as the primary contact for providers and their staff, assisting in contract management and providing analytical support to ensure the effectiveness of network operations. The analyst will be responsible for developing and maintaining positive relationships with physicians, providers, and practice managers, which is crucial for the success of various incentive-based and value-based programs. In this role, the analyst will provide tactical operations support to assigned groups, which includes responsibilities such as contracting, credentialing, data integrity, and relationship management. The position requires the completion of orientation and onboarding for new physicians, as well as the creation and delivery of educational materials to inform providers and their staff about contracts, policies, procedures, and performance metrics. Regular visits to primary care providers (PCPs) and specialists are essential, with the analyst expected to document all interactions in Salesforce and prepare presentations for operational meetings. The analyst will also be tasked with understanding and reporting on key program performance metrics, conducting root cause analyses for provider concerns, and collaborating with various internal departments to develop strategic solutions. This role is designed for individuals who are detail-oriented, possess strong analytical skills, and can effectively communicate with diverse stakeholders. The position requires a commitment to fostering positive relationships and driving performance improvements across the network.

Responsibilities
? Provide tactical operations support to assigned groups, including contracting, credentialing, data integrity, communications, and relationship management
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? Complete orientation/onboarding of new physicians
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? Create and deliver materials to educate providers and provider staff on contracts, policies and procedures, quality and service line initiatives, and financial performance
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? Visit all PCPs monthly
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? Schedule recurring monthly meetings with key staff with PCPs on a performance improvement plan
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? Include all support team members including performance improvement team
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? Visit capped specialists every other month
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? Visit fee for service specialists quarterly
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? Ensure all provider interactions are documented in Salesforce
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? Prepare and deliver presentations with providers, provider staff, and/or physician leadership during monthly operational meetings
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? Collaborate and present at office staff meetings
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? Understand, develop, track, monitor and report on key program performance metrics, such as utilization, coding, and STARs/quality performance
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? Perform root cause analyses and resolution related to provider concerns, grievances, claims and care delivery
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? Prepare materials and participate in monthly financial review with senior leadership
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? Partner with other internal departments, including but not limited to Health Services, Finance, Claims, and Coding in order to develop solutions for strategic business needs
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? Work closely with internal representatives for needs and support
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? Other Duties as assigned

Requirements
? Bachelor's degree preferred (with a Healthcare concentration)
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? 2+ years of experience in healthcare administration or provider relationship management preferred
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? Detail oriented, with proven time management and organization skills
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? Ability to engage in multiple tasks and meet deadlines/standards
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? Strong analytical and problem-solving skills
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? Excellent communication skills - verbal, written and presentation
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? Basic to Intermediate level of Excel preferred (knowledge of pivot tables, VLOOKUP, etc.)

Nice-to-haves

Benefits

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