Business Analyst

Job Description

Job Description

Description

About the Role
We are currently seeking a highly motivated Business Analyst, Market Provider Relations to support our Texas Market Provider Relations team. This role reports to the Texas Market Provider Relations Leader and will provide analytical, reporting, operational, and project support across multiple provider networks, IPAs, ACOs, and delegated health plan arrangements throughout the Texas market.

The ideal candidate is highly analytical, detail-oriented, and organized, with the ability to translate complex healthcare data into actionable insights. This role will play a key part in supporting provider satisfaction, operational excellence, health plan delegation readiness, and value-based care initiatives while helping leadership manage provider-related priorities and market performance.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• Support Texas Market Provider Relations leadership by tracking provider issues, health plan escalations, operational initiatives, and market priorities.
• Develop and maintain reports, dashboards, and analytics related to provider performance, membership, claims, authorizations, quality, utilization, risk adjustment, and value-based care outcomes.
• Analyze provider and market data to identify trends, risks, gaps, and opportunities, and present actionable recommendations to leadership.
• Support health plan delegation activities, including provider roster validation, provider loading, configuration issues, claims and authorization routing concerns, and escalation management.
• Assist with ACO recruitment tracking, provider participation, performance reporting, and value-based care initiatives.
• Coordinate cross-functional projects, including market transitions, health plan implementations, provider engagement initiatives, delegation readiness activities, and operational improvement efforts.
• Prepare materials, reports, and summaries for provider meetings, Joint Operating Committees (JOCs), leadership meetings, board meetings, and executive presentations.
• Track project timelines, action items, deliverables, and follow-up activities to support successful market execution.

Qualifications

• Bachelor's degree in Business, Healthcare Administration, Finance, Data Analytics, Public Health, or a related field preferred.
• Minimum of 3 years of experience in healthcare operations, provider relations, managed care, business analysis, data reporting, or project coordination.
• Strong proficiency in Microsoft Excel, including pivot tables, VLOOKUP/XLOOKUP, formulas, filtering, and data validation.
• Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities, deadlines, and stakeholders in a fast-paced environment.
• Ability to work independently while collaborating across cross-functional teams.

Preferred Qualifications

• Experience working with provider networks, IPAs, ACOs, MSOs, health plans, or value-based care organizations.
• Experience with EZCap, Monday.com, Clarity, Power BI, health plan portals, provider rosters, claims reporting, or healthcare analytics tools.
• Knowledge of Medicare Advantage, Medicaid, MSSP ACO, ACO REACH, delegated claims, delegated authorizations, credentialing, and provider configuration processes.
• Experience supporting executive reporting, provider issue management, market operations, or healthcare project initiatives.

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.