Network Operations, Senior Analyst

CVS Health•Work At Home-Louisiana, LA

19h•$46,988 - $91,800

About The Position

The Senior Analyst, Network Operations is a senior individual contributor within Network Operations, responsible for business operations managing Aetna’s provider network, which accounts for more than $30 billion in annual medical claims spend. Responsibilities may include facilitating new provider applications, managing provider inquiries and assistance requests, and maintaining current provider data and demographic information. The role may focus on specific aspects of provider application, inquiry, or data integrity processes. The role has broad influence over its areas of responsibility and requires accurate decisions about processes and work direction, along with interactions with appropriate local market colleagues. The Senior Analyst identifies and acts on trends affecting market objectives and uses independent judgment, discretion, and authority. The position applies professional and technical experience, knowledge of Aetna systems, and cross-functional relationships to handle responsibilities, including common and non-standard provider requests or situations. The Senior Analyst works with multiple business areas to ensure timely completion of work and meets department-defined production volume and turnaround-time standards.

Requirements

At least 3 years of experience in a network or related business environment, with exposure to provider systems and processes.
Strong organizational skills and demonstrated ability to balance multiple concurrent priorities.
Strong communication, critical thinking, problem-resolution, and interpersonal skills.
Working knowledge of business systems, applications, and tools.
Experience with desktop tools, including Microsoft Office.
Bachelor’s degree or equivalent combination of education and experience.

Nice To Haves

Experience working with provider data and internal systems EPDB, PDMS, PRMS, and SCM.
Strong research skills.
Ability to manage expectations, multitask, and maintain strong internal and external relationships.
Independent thinking and strong analytical skills.

Responsibilities

Manage business operations for Aetna’s provider network.
Facilitate new provider applications.
Manage provider inquiries and assistance requests.
Ensure provider data and demographic information is maintained accurately and current.
Make decisions about processes and work direction and interact with appropriate local market colleagues.
Identify, evaluate, and act on trends affecting market objectives.
Handle common and non-standard provider requests and situations using Aetna systems knowledge and cross-functional relationships.
Coordinate with multiple business areas to ensure timely completion of work.
Meet department-defined production volume and turnaround-time standards.