Government Provider Operations Analyst

About the Role

Join the team leading the next evolution of virtual care. At Teladoc Health, you are empowered to bring your true self to work while helping millions of people live their healthiest lives. Here you will be part of a high-performance culture where colleagues embrace challenges, drive transformative solutions, and create opportunities for growth. The Government Provider Operations Analyst is responsible for managing the Teladoc Health Medical Group Medicare and Medicaid provider networks.

The role involves working closely with Clinical Operations teams and directly with Teladoc Health Medical Group, P.A. (THMG) practitioners to complete group and individual Medicare/Medicaid enrollment applications, verify and manage Medicaid network composition, manage affiliation status between group and individual practitioners, and provide network reporting.

Responsibilities

• Manage individual practitioner Medicare and Medicaid networks (60%):
  • Perform periodic verification of individual practitioner enrollment status in Medicare and Medicaid programs
  • Affiliate Medicaid enrolled individual practitioners to THMG Medicaid group enrollments
  • Provide administrative support to individual practitioners to complete Medicaid enrollment applications, including pre-populating application data, collecting required documents, and submitting applications to Medicaid agencies
  • Add/remove individual practitioners from Medicare/Medicaid networks on consultation platform
• Support THMG group enrollments (15%):
  • Complete group Medicaid enrollment applications by collecting required documents, completing and submitting application forms, and communicating directly with Medicaid agencies throughout approval process
  • Complete periodic Medicaid revalidation applications
  • Update group enrollments to reflect current THMG network composition
• Complete network reporting and analytics (10%):
  • Generate monthly reports of Medicare/Medicaid network status
  • Produce monthly reports of individual progress towards Key Performance Indicators (KPIs)
  • Provide ad-hoc reporting to investigate Medicare/Medicaid claims discrepancies
  • Offer other reporting and analytics support as assigned
• Act as subject matter expert in assigned Medicare/Medicaid networks (10%):
  • Author thorough and up-to-date documentation of assigned network processes
  • Possess a deep understanding of individual and group enrollment requirements
  • Respond to inquiries throughout the organization
• Other duties as assigned (5%)

The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs.

Requirements

• High school diploma (or equivalent)
• Strong verbal and written communication skills; ability to effectively communicate to all levels of constituents, including providers, team members, and senior management
• Effective presentation skills and ability to lead discussions in group environments
• Ability to work independently and collaboratively
• Capable of thriving in a fast-paced environment
• High energy level, enthusiastic, and eager to do what is necessary to be successful
• Ability to adapt to change quickly while meeting aggressive deadlines
• Detail-oriented, analytical, and organized
• Intermediate-level skills in Microsoft applications such as Excel, PowerPoint, Word, and Outlook

Preferred qualifications (not required):

• 1-2 years’ Medicare/Medicaid network management experience
• 2-3 years’ experience in a healthcare administrative/operations environment

Work Environment

• Location: Remote
• Travel: ≤10% (estimate, subject to change based on business needs)

Pay

The base salary range for this position is $65,000 - $75,000. In addition to a base salary, this position is eligible for a performance bonus and benefits.

Benefits

• Flexible Vacation Policy (all time off must be approved by your manager)
• 80 hours of Paid Sick, Safe, and Caregiver Leave annually (full-time positions only)
• Comprehensive benefits program tailored to you and your family (eligibility requirements apply)

About Us

Teladoc Health is the global virtual care leader, offering the only comprehensive virtual care solution spanning telehealth, expert medical, and licensed platform services. Teladoc Health serves the world's leading insurers, employers, and health systems and helps millions of people around the world resolve their healthcare needs with confidence.