Analyst - Medicaid Network Operations
Core
Support the Medicaid Network management team throughout the provider contracting lifecycle for Aetna Better Health of Illinois, ensuring accuracy of provider contract documentation and database integrity.
Role type
Contract Coordinator Analyst
Builds
Provider record database entries and master repository of participating provider contracts
Domain
Healthcare / Medicaid Network Operations
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
TriZetto QNXT, medical terminology, Microsoft Office Suite, contract document review, database auditing, email triage, regulatory compliance reporting
Preferred skills
SQL Database Queries, Microsoft Excel (formulas and pivot tables), business reporting
Responsibilities
Review incoming contractual documents for completeness; load newly contracted providers to the provider record database; audit updated provider records; maintain master repository of provider contracts; respond to provider and internal staff inquiries regarding participating status; compile and report on compliance with contract submission rules; assist with claims projects and audits.
Seniority
Mid-level, hands-on IC