Job Description

Location: Steward Health Care Network
Posted Date: 4/20/2022

Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world-class doctor close to where they live.

The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.

Position Purpose: Reporting to the Provider Enrollment Supervisor, the Provider Enrollment Analyst manages the accurate and efficient data of SHCN providers with health plan contracts.

  • Coordinates all operational aspects of maintaining accurate SHCN provider data with SHCN-contracted managed care health plans working closely with other SHCN Managers, SHCN Provider Enrollment, and network representatives. Specifically, the Provider Enrollment Analyst is responsible to: manage, reconcile, and analyze SHCN provider data for accurate and continuous maintenance with SHCN and contracted health plans
  • Develop close and collaborative working relationships with provider and local chapter offices to streamline the accurate submission of information to the health plans and to SHCN. Work closely with SHCN, its affiliates, and the health plans to reconcile any differences in listings of enrolled SHCN physicians. Coordinates these efforts with and through the local chapter offices and SMG Provider Enrollment and works with SHCN Analytic Team to implement changes in provider data
  • Conducts ongoing audit of the process to ensure accuracy of provider data. Ensure that SHCN has an accurate and up-to-date listing of all employed and SHCN affiliated physicians at all times and that each of the contracted health plans does as well
  • Identifies opportunities for improvements in the process and develops strategies to implement appropriate changes/enhancements; Develops partnerships with relevant staff at the health plans in coordinating enrollment of SHCN providers; independently troubleshooting issues as they arise
  • Maintain ongoing participation in cross-training activities, ensuring appropriate staff coverage of incoming volume. Actively engage in addressing special projects as they arise, conducting preliminary research and follow-up, and tracking/monitoring to facilitate ongoing reporting of project status. Provides valid feedback to the Provider Enrollment Supervisor on departmental issues and progress
  • Perform other functions as assigned

Education / Experience / Other Requirements

Education:

  • Associate degree in a related field (or equivalent combination of education and experience)

Years of Experience:

  • A minimum of 2 years of data analytics, provider/customer relations, data entry, and/or project management, preferably within a healthcare environment

Specialized Knowledge:

  • High proficiency in Microsoft Excel and, preferably, experience in SQL and Database management
  • Previous Managed Care and/or Medicaid experience strongly preferred
  • Ability to analyze and evaluate data and other provider related problems in order to develop alternative solutions for a positive outcome
  • Collaborative and relationship-driven style in building effective data transmissions between entities
  • Strong ability to problem solve and proven ability to learn quickly and work independently
  • Ability to multi-task and prioritize workload, manage multiple priorities, and pay meticulous attention to detail
  • Thorough understanding of managed care principles and physician practice operations, with an understanding of health plan provider enrollment and credentialing preferred
  • Excellent organizational skills, proven project management expertise; Strong verbal and written communication skills
  • Outstanding interpersonal skills, able to quickly establish a trusting rapport with individuals at all levels
  • Requisite poise, judgment, and trustworthiness to represent SHCN to internal and external groups
  • Maintains information in a confidential manner according to policy

This position is subject to the COVID-19 Vaccination Policy for Steward Health Care Workforce. Employees in this position will be required to provide adequate proof of vaccination for COVID-19 by an FDA-approved vaccine prior to starting work. Steward will consider requests for exemptions from this vaccine requirement on the basis of medical condition or sincerely held religious belief in accordance with applicable Federal laws.

Steward Health Care is an Equal Employment Opportunity (EEO) employer. Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.


Additional Information

Steward Health Care Network is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment – with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience:

  1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
  2. A stringent cleaning policy has been implemented throughout our facilities.
  3. A strictly controlled visitor and masking policy is required for patient and colleague safety.

You can rest assured that we have made the necessary preparations to provide care in a safe, controlled and professional way.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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