Overview
Full Time
Part Time
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 6
Skills
sql
facets
cactus
provider network
Job Details
Provider Network Analyst III
remote
Provider Network Analyst III role for one of our health plan clients. This is a remote contract through the end of the year (potential for extension) for our health plan client, EST hours. This role will be focused on ensuring operational effectiveness and supporting strategic goals. Key responsibilities include analyzing provider data for consistency, resolving escalated issues, monitoring SLAs, and collaborating with internal and external stakeholders on provider setup, claims processing, and reimbursement processes.
Key Skills & Experience:
- Proficiency in Facets (provider setup, troubleshooting, data validation), SQL, and Cactus credentialing.
- Strong knowledge of claims payment processes and provider data management.
- Ability to triage tickets, analyze root causes, and recommend actionable solutions.
- Effective communication, collaboration, and problem-solving skills.
- Experience with performance/process improvement methodologies is a plus.
- Excel experience
Please send candidate in a separate email, we need to know how many years of experience with the following:
- Facets
- SQL
- Cactus
- Provider Data Research and Analysis
- Excel
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.