Provider Relations Analyst - The Health Plan

 
Position: Provider Relations Analyst - The Health Plan

Job ID: 164185

Location: US-TX-Houston

Department: PROVIDER RELATIONS RESPONSE

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.  At Texas Children’s Hospital, diversity, equity, and inclusion are at the core of our values and mission for all of the patients and families that we serve. We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Provider Relations Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for provider data management/governance and inquiry research, response, and resolution for all provider groups in the TCHP network. This includes collaboration with other departments and a review of regulatory requirements. The position is responsible for comprehensive reviews of our provider data to identify areas of concern for TCHP's provider network, mainly in regard to TCHP's Delegated provider groups. The position interacts with physicians, directors, managers, and peers on a daily basis to gather the information required to complete their work. The position is responsible for partnering with their peers to complete major departmental projects including data research, investigation of issues, and development of Standard Operating Procedures.

 

Think you’ve got what it takes



Responsibilities :

Job Duties & Responsibilities

  • Research, develop, and implement a coordinated approach to provider inquiries
  • Provider Data Management
  • Provider Focused Customer Service
  • Participate in TCHP improvement projects, programs, and initiatives to support the mission and strategic imperatives of the organization


Qualifications:

 

Skills & Requirements

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s unless approved for a medical or religious exemption.
  • Required High School Diploma or GED with a preferred Bachelor's Degree
  • 4 years health care administration, managed care, or customer service experience


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