Network Administration Analyst
3 weeks ago
Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today
Learn more about our unique benefit offerings here.
Want to know more? You can learn about life at Wellmark here.
Job Description
Help us lead change and transform Wellmark's business
The health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We've embarked on a journey to support our members use and navigate the health care system in order to help them make clear, informed decisions, and we're also ensuring that we take a team-centric approach when working with and in support of our members. The work that our diverse business and care teams are doing in collaboration with our health care partners will create these changes, all while working to minimize health care costs.
Use your strengths as Network Administration Analyst at Wellmark
Analysts will conduct provider credentialing, recredentialing, contracting, maintenance, and payment activities for Wellmark provider networks. This individual will ensure providers meet credentialing and contracting criteria and are set up for accurate provider reimbursement for claims adjudication.
Ideal candidates possess health care related experience and have worked within production-based environments where quality goals, accuracy, time management, and attention to detail are crucial to success. Top candidates will have provider contracting and/or credentialing experience.
Qualifications
Required:
- High School Diploma or GED
- 1+ years of experience working in a fast-paced environment where production and/or quality goals were measured. Demonstrated commitment to timeliness, prioritization, accuracy, and attention to detail as it applies to process, guidelines, etc.
- Experience working in a health care related environment, such as provider office setting, insurance operations, provider network administration, contracting, credentialing, or similar area.
- Strong written and verbal communication skills with the ability to clearly and concisely communicate information to stakeholders.
- Ability to develop professional customer relationships by listening, understanding, anticipating, and providing solutions to customer needs.
- Strong problem solving skills.
Additional Information
a. Conduct provider credentialing, re-credentialing, contracting, maintenance, and payment activities timely for Wellmark networks. Provide written communication directly to providers through notification letters.
b. Organize information for Credentialing Committee action (e.g. Clear Pass, Needs Review) based on NCQA guidelines.
c. Assist with the monthly mailing of re-credentialing applications and perform follow up based on documented work instructions to ensure completion of process within timeframes assigned.
d. As assigned, manage the delegation relationship and contracting and credentialing activities with key provider organizations that perform credentialing and re-credentialing functions on behalf of Wellmark.
e. Maintain provider databases accurately and timely in order to support claims processing, provider data reporting, data transfers to external vendor files and directory publication for all Wellmark networks. Perform provider pricing updates accurately and timely as identified.
f. Maintain multiple internal databases for provider number matching to meet HIPAA mandates and for crossover claims from other payers to ensure Wellmark processes claims accurately and timely for providers and members.
g. Act as a subject matter expert in support of Network Administration Operations responding to provider inquires related to network participation, status of enrollment process, and overall provider record information.
h. Process provider contract terminations timely and accurately to ensure that our members receive the appropriate benefits. Issue formal termination letter to provider along with notification to internal and external parties, as appropriate.
i. Participate in audits initiated internally and by external vendors such as BCBS Association, as well as self-audits, to document compliance with department policies as part of daily operations.
j. Research data base maintenance reports designed to identify errors that will impact provider data sent to outside vendors.. Correct data, modify data policies and process steps to eliminate errors, if needed.
k. Meet both quality assurance and production metrics established by Network Administration leadership.
l. Collaborate and work as a team to coordinate and integrate responses and actions with other network management team members as well as across the department and with other internal partners such as claims or customer/provider service.
m. Demonstrate understanding and accurate interpretation to support compliance with regulatory standards e.g. NCQA and HIPAA. Professionally handle confidential and protected health information.
n. Other duties as assigned.
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com
Please inform us if you meet the definition of a "Covered DoD official".
-
Network Administration Analyst
4 weeks ago
Des Moines, United States Wellmark Full timeCompany DescriptionWhy Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you're passionate about joining an organization...
-
Network Administrattion Analyst
4 weeks ago
Des Moines, United States Wellmark Full timeJob Description Help us lead change and transform Wellmark's business The health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We’ve embarked on a journey to support our members use and navigate...
-
Network Administrattion Analyst
5 days ago
Des Moines, Iowa, United States Wellmark Full timeJob DescriptionHelp us lead change and transform Wellmark's businessThe health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We've embarked on a journey to support our members use and navigate the...
-
Network Administrator
1 month ago
Des Moines, United States TMC Transportation Full timeTMC Transportation is the nation’s largest employee-owned, open deck transportation company. Founded in 1972, and headquartered in Des Moines, Iowa, TMC provides expert transportation services and supply-chain management solutions throughout the 48 contiguous states. If you’re seeking a rewarding career at a dynamic company built on integrity, innovation...
-
Network Administrator
1 month ago
Des Moines, United States TMC Transportation Full timeTMC Transportation is the nation's largest employee-owned, open deck transportation company. Founded in 1972, and headquartered in Des Moines, Iowa, TMC provides expert transportation services and supply-chain management solutions throughout the 48 contiguous states. If you're seeking a rewarding career at a dynamic company built on integrity, innovation and...
-
Network Systems Administrator
4 weeks ago
Des Moines, United States Hytek Finishes Co. Full timeNetwork Systems Administrator Reports to: Director of IT Works with: IT Staff, Business Unit Staff, Vendors, Consultants Location: Kent, WA | Onsite Schedule: Full Time, Monday through Friday Type: Exempt Role Overview The Network Systems Administrator is a critical role for the organization. This role is responsible for managing the network, infrastructure,...
-
Network Systems Administrator
3 weeks ago
Des Moines, United States Hytek Finishes Co. Full timeNetwork Systems Administrator Reports to: Director of IT Works with: IT Staff, Business Unit Staff, Vendors, Consultants Location: Kent, WA | Onsite Schedule: Full Time, Monday through Friday Type: Exempt Role Overview The Network Systems Administrator is a critical role for the organization. This role is responsible for managing the network, infrastructure,...
-
Network Support Analyst
4 weeks ago
Des Moines, United States The Weitz Company Contrack Watts, Inc. Full timeJob DescriptionJob DescriptionSalary: Our Company views employees as our most valuable asset, and the key to our success. We are committed to growing a diverse and inclusive culture that inspires, motivates, and continuously improves. Community involvement, employee empowerment, and strong relationships makes The Weitz Company a great place to work. The...
-
Network Support Analyst
3 weeks ago
Des Moines, United States The Weitz Company Contrack Watts, Inc. Full timeJob DescriptionJob DescriptionSalary: Our Company views employees as our most valuable asset, and the key to our success. We are committed to growing a diverse and inclusive culture that inspires, motivates, and continuously improves. Community involvement, employee empowerment, and strong relationships makes The Weitz Company a great place to work. The...
-
soc analyst 1
5 days ago
Des Moines, Iowa, United States TalentBridge Full timeJob Title: Security Analyst (SA)Position: SOC Analyst 1Position Overview: The Security Analyst (SA) is responsible for understanding all aspects of computer and network security, including firewall administration, encryption technologies, and network protocols. This role supports the Security Operations Center (SOC) and provides tier one triage for...
-
Security Analyst
2 weeks ago
Des Moines, United States Maven Workforce INC Full timeJob DescriptionJob DescriptionJob Title: Security AnalystLocation: Des Moines, IASummary:The Security Analyst (SA) has an understanding of all aspects of computer and network security, including such areas as firewall administration, encryption technologies and network protocols.This position supports the Chief Information Officer (OCIO), Security Operations...
-
Manager - Systems & Network Administrator
5 days ago
West Des Moines, Iowa, United States Merchants Bonding Company Full timeBUILD YOUR CAREER AT MERCHANTS Are you a determined individual and creative problem-solver looking to join a collaborative team? We value communication and purpose-driven work, so we are excited to find someone like you who thrives in an environment where they can make a real impact. If you are passionate about your work and want to be part of an innovative...
-
Manager - Systems & Network Administrator
4 weeks ago
West Des Moines, United States Merchants Bonding Company Full timeBUILD YOUR CAREER AT MERCHANTSAre you a determined individual and creative problem-solver looking to join a collaborative team? We value communication and purpose-driven work, so we are excited to find someone like you who thrives in an environment where they can make a real impact. If you are passionate about your work and want to be part of an innovative...
-
Manager - Systems & Network Administrator
3 weeks ago
West Des Moines, United States Merchants Bonding Company Full timeBUILD YOUR CAREER AT MERCHANTSAre you a determined individual and creative problem-solver looking to join a collaborative team? We value communication and purpose-driven work, so we are excited to find someone like you who thrives in an environment where they can make a real impact. If you are passionate about your work and want to be part of an innovative...
-
Soc Analyst 1
2 weeks ago
Des Moines, United States DKMRBH Inc Full timeJob DescriptionJob DescriptionPosition: Soc Analyst 1Location: Des Moines, IA 50319 (Hybrid)The Security Analyst (SA) has an understanding of all aspects of computer and network security, including such areas as firewall administration, encryption technologies and network protocols.This position supports the Client's Office of the Chief Information...
-
Soc Analyst 1
2 weeks ago
Des Moines, United States DKMRBH Inc Full timeJob DescriptionJob DescriptionPosition: Soc Analyst 1Location: Des Moines, IA 50319 (Hybrid)The Security Analyst (SA) has an understanding of all aspects of computer and network security, including such areas as firewall administration, encryption technologies and network protocols.This position supports the Client's Office of the Chief Information...
-
SOC ANALYST
2 weeks ago
Des Moines, United States Cays Inc Full timeJob DescriptionJob DescriptionThe Security Analyst (SA) has an understanding of all aspects of computer and network security, including such areas as firewall administration, encryption technologies and network protocols. CandidateRequirements: Knowledge of securitytechnologies, including but not limited to firewall, IDS, policy management,security...
-
SOC ANALYST
2 weeks ago
Des Moines, United States Cays Inc Full timeJob DescriptionJob DescriptionThe Security Analyst (SA) has an understanding of all aspects of computer and network security, including such areas as firewall administration, encryption technologies and network protocols. CandidateRequirements: Knowledge of securitytechnologies, including but not limited to firewall, IDS, policy management,security...
-
Technical Support Analyst
5 days ago
Des Moines, Iowa, United States Palmer Group Full timeJob DescriptionJob DescriptionWe are seeking a customer-focused, critical-thinking Technical Support Analyst. As a Technical Support Analyst, you will play a vital role in providing first-level support, diagnosing issues, and ensuring customer satisfaction. Support may include looking at file extracts to establish submission error causes, helping customers...
-
Des Moines, United States TPI Composites Full timeIT Helpdesk Analyst – Field Services Des Moines, IA (On-site) Position Summary The IT (Information Technology) Helpdesk Support Analyst will provide maintenance of the computer desktop environment by analyzing requirements, resolving problems, installing hardware and software solutions, and supporting the internal IT Helpdesk. You will handle...
