What you'll get to do:

The Provider Network Operations Analyst II is responsible for creating the claims system reimbursement structure for clinic and ancillary providers based on the legal provider contract for Medica's following products:

• Commercial Group
• Individual
• Government
• PPO
• LaborCare
• PatientChoice/Insight

The Provider Network Operations Analyst II is responsible for the accuracy of the provider reimbursement within the COSMOS, COPIS and UNET platforms for more complex payment methodologies.

The Provider Network Operations Analyst II will be responsible for day to day issues, interpretation of all provider contracts, collaboration with other departments and accurate creation and input of the provider contract reimbursement. This position works cross-functionally with and acts as a subject matter expert on the provider contract installation process.

Qualifications:

• Bachelors degree required
• 2 years experience in managed care and insurance products and services preferred
• Relevant work experience in provider contracting/installation preferred
• Relevant work experience working with outsourced business processes preferred
• COSMOS COPIS and/or NetworksPro database knowledge a plus
• Medica SelectCare, LaborCare and/or Patient Choice product knowledge and experience preferred
• Ancillary knowledge a plus

Skills and Abilities:

• Strong PC skills including Microsoft applications (NT, Word, Excel, Project, PowerPoint and Access) and Visio (or equivalent)