Business Analyst

Department: ApolloCare TX - Provider Relations Location: 19500 HWY 249, Suite 570 Houston, TX 77070 Compensation: $75,000.00 - $85,000.00 / hour Job Title: Business Analyst, Market Provider Relations Department / Function: Provider Relations / Market Operations Reports To: Texas Market Provider Relations Leader Location: Texas Market FLSA Status: Exempt The Business Analyst, Market Provider Relations, will provide dedicated analytical, reporting, operational, and project support to the Texas Market Provider Relations leadership team. This role is responsible for organizing provider‑level data, tracking market initiatives, supporting issue resolution, preparing leadership reporting, and identifying trends that impact provider satisfaction, network performance, delegation readiness, and value‑based care outcomes. The Texas market includes multiple IPAs, ACOs, delegated health plan arrangements, and provider networks across Houston, Beaumont and surrounding service areas. The Business Analyst will support leadership in managing complex provider‑related priorities, including claims and authorization issues, roster accuracy, provider loading concerns, ACO recruitment, quality and risk initiatives, health plan escalations, contract transition tracking, and market‑level performance reporting. This role is critical to improving operational visibility, strengthening accountability, and allowing Provider Relations leaders to focus on provider engagement, strategic issue resolution, and market execution. Essential Duties and Responsibilities Support the Market Provider Relations leader and leadership team with day‑to‑day operational tracking, issue documentation, and follow‑up on provider‑facing priorities. Maintain market‑level trackers for provider issues, escalations, claims concerns, authorization concerns, configuration issues, roster discrepancies, and health plan follow‑up items. Ensure leadership has accurate, timely and organized information to support provider meetings, Joint Operating Committees, internal leadership meetings, and executive updates. Track action items assigned to leaders and team members, including owners, due dates, status updates, barriers, and next steps. Develop and maintain recurring reports and dashboards to support leadership decision‑making. Analyze provider‑level and practice‑level data related to membership, claims, authorizations, quality gaps, risk adjustment activity, utilization, ACO participation, and financial performance. Prepare summary reports that identify trends, risks, gaps, and opportunities across the Texas market. Support analysis of provider performance trends, including quality, cost, utilization, readmissions, membership movement, and value‑based care performance. Create executive‑level summaries and market updates that translate complex data into clear, actionable insights. Support tracking and analysis of health plan delegation issues, including provider loading, roster accuracy, effective dates, claims routing, authorization routing, payer ID issues, and provider directory concerns. Assist with reviewing health plan rosters, internal provider data, EZCap records, and market tracking tools to identify discrepancies and escalation needs. Maintain documentation of open health plan issues and support follow‑up with internal teams, health plans, and leadership. Track provider concerns related to WellCare, WellPoint, SCAN, Humana, Aetna, Cigna, Ambetter, and other delegated or contracted health plan arrangements. Support ACO recruitment tracking, provider participation documentation, TIN/NPI validation, deadline management, and submission readiness. Assist with provider‑level analysis related to ACO eligibility, performance, membership, quality gaps, utilization trends, and financial opportunity. Maintain ACO recruitment and participation trackers to ensure leadership has visibility into progress, barriers, and outstanding provider follow‑up. Support development of provider‑facing reports and internal summaries for ACO discussions, office hours, board meetings, and leadership updates. Provide project support for market initiatives, including IPA transitions, new health plan go‑lives, provider engagement campaigns, contracting transitions, delegation readiness, and operational improvement efforts. Maintain organized project plans, timelines, status updates, and deliverable tracking for key market initiatives. Partner with multiple internal teams to gather updates and support issue resolution. Identify gaps in process, documentation, reporting, or follow‑up and recommend improvements to support stronger market execution. Prepare materials for provider meetings, internal leadership meetings, JOCs, board meetings, and executive discussions. Summarize key issues, trends, and recommended next steps for leadership review. Assist with creating provider‑level summaries that support informed discussions around performance, concerns, opportunities, and escalation items. Document, assign, track, and complete meeting follow‑up items. Knowledge, Skills, and Abilities Strong analytical skills with the ability to review, organize, and interpret large amounts of provider, claims, roster, quality, and operational data. Ability to translate complex data into clear summaries, dashboards, and actionable recommendations. Strong attention to detail and ability to identify discrepancies across multiple systems and reports. Excellent organizational and follow‑up skills with the ability to manage multiple priorities, deadlines, and stakeholders. Strong written and verbal communication skills. Ability to work independently while also collaborating across multiple internal departments. Understanding of provider relations, managed care, IPAs, ACOs, delegation, claims, authorizations, quality, risk adjustment, and value‑based care is preferred. Ability to maintain confidentiality and handle sensitive provider, patient, and business information appropriately. Required Qualifications Bachelor’s degree in Business, Healthcare Administration, Finance, Data Analytics, Public Health, or related field preferred. Minimum of 3 years of experience in healthcare operations, provider relations, managed care, business analysis, data reporting, or project support. Experience working with provider networks, health plans, IPAs, ACOs, MSOs, or value‑based care organizations preferred. Strong proficiency in Microsoft Excel, including pivot tables, VLOOKUP/XLOOKUP, formulas, filtering, and data validation. Experience with reporting tools, dashboards, project management platforms, or healthcare operating systems preferred. Preferred Qualifications Experience working with EZCap, Monday.com, Clarity, Power BI, health plan portals, claims reports, provider rosters, or value‑based care reporting tools. Knowledge of Medicare Advantage, Medicaid, ACO REACH, MSSP ACO, delegated claims, delegated authorizations, credentialing, and provider configuration processes. Experience supporting executive‑level reporting, provider issue tracking, market operations, or cross‑functional healthcare projects. You're Great for This Role If You Enjoy working with data and turning insights into actionable business decisions. Have strong attention to detail and can identify discrepancies across multiple reports and systems. Thrive in a fast‑paced environment while managing competing priorities and deadlines. Are highly organized with strong follow‑through and accountability. Build strong relationships and communicate effectively with stakeholders across all levels of the organization. Have a provider‑focused mindset and a passion for improving healthcare operations. Continuously seek opportunities to improve processes, reporting, and operational efficiency. Environmental Job Requirements and Working Conditions This position may operate in a hybrid environment with a combination of office and remote work based on business needs. Frequent use of computers, reporting systems, spreadsheets, and healthcare operating platforms. Ability to attend provider meetings, leadership meetings, and other business‑related events as required. May require occasional travel within the Texas market. #J-18808-Ljbffr Astrana Health