Southwestern Health Resources CIN seeks to hire a Network Facility and Ancillary Analyst to work full time for their Network Development Department.
Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health employee.
The address is 8150 Brookriver Drive, Dallas, TX 75247.
Salary range is Min. $21.24/hr. to Max. $34.32/hr. – based on relevant experience
The position is designed to support contractors in network gap identification, support network in adequacy identification and be the conduit between network and providers. The position will be expected to understand network relationships, validate data and network accuracy, identify network gaps and ensure compliance with CMS requirements as it pertains to the health plans.
- Describe requirements, terms of contract, performance requirements, etc.
- Perform network gap analysis to identify unmet parts of the service area.
- Work in conjunction with the contracting department to fill identified gaps.
- Make sure contracts are loaded into all other necessary systems (claims, UM, credentialing, etc.)
- Receive and process all incoming network issues and resolve.
- Able to enter information into Master Data Manager and ensure quality.
- Supervise quality assurance staff.
- Validates data for quality improvement.
- Run provider directories and rosters as needed.
- Use external sources to validate accuracy of physicians, groups, facilities and any other provider.
- Document process, policy and procedure.
- Audits data on quarterly basis.
- Other additional duties to meet the ongoing needs of the organization.
The ideal candidate will possess the following qualifications:
- Bachelor's Degree in Healthcare, Business or related field required
- 5 years' experience in provider or health plan contracting, network development, business development, and/or strategic planning required
- Experience with Mapping Software Maptitude and SQL highly preferred
- Experience with Quest Analytics tool, Sales Forces, and/or Cactus a plus
- Must be proficient in relevant computer applications such as Microsoft Office
- Must be detail oriented
- Must be dependable, exhibit strong initiative, and be self-motivated
- Must possess excellent communication skills
- Must be able to frequently problem solve, make decisions, interpret data, organize and analyze work flow, write, plan, and use simple arithmetic.
- Organization: Texas Health Resources
- Location: Dallas, Texas, United States
- Overtime Status: Exempt
- Shift: Day Job
- Schedule: Full-time
- Pay Basis: Hourly
- Minimum Salary: US Dollar (USD) 21.24
- Market Salary: US Dollar (USD): 26.80
- Maximum Salary : US Dollar (USD) 34.32