Analyst – Medicaid Network Operations

Job not on LinkedIn

🔥 5 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $47k - $112.2k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🌐 Network Operations

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Review incoming contractual documents for completeness and accuracy • Obtain missing or incomplete documents from contracting staff • Load newly contracted providers into the provider record database • Audit provider records and submit corrections • Maintain the repository of participating provider contracts • Manage and triage the contracting team email inbox • Research and respond to provider and internal staff inquiries about contractual matters • Send welcome packets to newly contracted providers • Support internal contract auditing processes • Compile, summarize, and report on compliance with contract submission rules and exception requests monthly • Assist with claims projects, audits, and contract and plan document reviews • Ensure compliance with health plan, corporate, state, and federal regulations • Escalate issues to management • Identify process improvement opportunities with Network Development and internal departments • Perform other assigned duties

🎯 Requirements

• 2–5 years of professional work experience, including 1 year in the healthcare industry • Experience working in TriZetto QNXT • Experience with medical terminology • Experience working with Microsoft Office Suite • Ability to manage multiple workflows, prioritize effectively, and meet deadlines • Strong written and verbal communication skills, with the ability to convey complex information clearly • GED required • SQL Database Queries preferred • Intermediate Microsoft Excel skills, including formulas and pivot tables, preferred • Business reporting preferred

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program

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