Actively hiring "Provider Network Operations Analyst (HRP Migration)" at New York NY (Hybrid) for position at a hospital. pay rate is $65-$70/Hr.
Please find below the Job Description:
- Job Title : Provider Network Operations Analyst (HRP Migration)
- Duration : 3-6+ (Extendable)
- Location : New York NY (Hybrid)
- Pay Rate : $65-$70/Hr.
Job Summary
We are seeking a detail-oriented Provider Network Operations Analyst to support the migration to HealthRules Payer (HRP), a core claims processing system. This role will work closely with cross-functional teams to ensure smooth implementation, accurate provider data management, and effective issue resolution throughout the migration lifecycle.
Key Responsibilities
- Support migration to HealthRules Payer (HRP) for Provider Network Operations (PNO)
- Participate in project meetings across all phases: planning, testing, and post-go-live
- Maintain and track PNO project issues, providing updates to leadership
- Assist in resolving provider-related issues during HRP implementation
- Update and maintain process documentation, policies, and procedures
- Prepare executive summaries and communications on project updates
- Represent leadership in operational and project meetings as needed
- Ensure provider data accuracy across systems (e.g., CACTUS, PowerStepp, HRP, Salesforce)
- Monitor and escalate provider complaints related to system migration
- Perform data analysis, reporting, and tracking for migration and operational issues
- Act as liaison across Credentialing, Provider Maintenance, and Customer Service teams
- Support additional PNO projects and operational initiatives as required
Qualifications
- Bachelor’s degree or equivalent experience
- 3–5 years of experience in a health plan environment (Medicaid preferred)
- Strong understanding of provider network operations and healthcare data structures
- Experience with system migrations or claims platforms preferred
- Excellent analytical, communication, and organizational skills
- Ability to manage multiple priorities in a fast-paced environment
Benefits:
Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
