What are the responsibilities and job description for the Medicaid Provider Operations Senior Analyst position at EssilorLuxottica Group?
Requisition ID : 875542
Position : Full-Time
Total Rewards : Benefits / Incentive Information
There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.
Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.
If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.
GENERAL FUNCTION
The Senior Analyst, Provider Relations is responsible for supporting the Network, Contracting, and Recruiting team as it relates to data analytics and reporting, specifically for projects related to Medicaid and / or Medical / Surgical products. This will include but is not limited to understanding state-by-state network geo / adequacy requirements, updating the associated network reports, assisting recruiting with developing an accurate recruiting list, and understanding client disruption. This position will also be responsible for researching and providing readouts for state-by-state Provider reimbursement and tracking associated changes in legislation.
MAJOR DUTIES AND RESPONSIBILITIES
- Lead data analysis and develop recommendations for Provider Relations projects and initiatives related to Medicaid / Med / Surg Recruiting, Network Management, and Provider Economics. Ensure recommendations align with organizational goals and other key stakeholders objectives
- Support the Provider Recruiting team with analysis of Provider Recruiting lists and claims disruption reporting. Support the team to organize data to identify appropriate targets and optimize the time of the recruiters
- Partner with the Provider Recruiting team to develop and maintain Medicaid and Medical / Surgical recruiting dashboards
- Work closely with the Network Management team to develop and maintain Network reporting related to GeoAdequacy, CMS Standards, and State specific requirements
- Support Network Management and Business configuration with Network and Agreement testing and post-go live validation and support
- Identify opportunities for network simplification and work with internal stakeholders to implement recommendations
- Work closely with Provider Communications, Provider Experience, and Call Center teams to ensure Recruiting and Network initiatives are supported with appropriate provider communications and interactions
BASIC QUALIFICATIONS
PREFERRED QUALIFICATIONS
Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and / or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off / vacation, and various employee discounts.
Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the EssilorLuxottica SpeakUp Hotline at 844-303-0229 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.
