Senior Provider Network Analyst

5 hours ago


Washington, Pennsylvania, United States State of Washington Full time
Job Summary

We are seeking a highly motivated and experienced Senior Provider Network Analyst to join our team in the Office of the Insurance Commissioner's Rates, Forms, and Provider Networks Division. The successful candidate will be responsible for supervising a team of Functional Program Analysts and ensuring the timely, consistent, and accurate analysis, evaluation, and approval or disapproval of statewide health, vision, and dental plan networks.

Key Responsibilities
  • Conduct job analysis and recommend duties for subordinate job descriptions
  • Develop performance expectations and conduct performance evaluations
  • Assign, plan, instruct, and check the work of assigned staff; coach and recognize staff
  • Determine schedules for assigned staff, including making recommendations
  • Approve or disapprove requests for outside employment and leave
  • Recommending or approving/disapproving (as delegated) employee training requests
  • Conduct supervisory fact-findings into alleged misconduct and/or performance deficiencies
  • Monitor staff workload and quality of work performed
  • Provide subject matter expertise regarding the nuances of Washington State's healthcare system, geographic barriers, and legal requirements
Requirements
  • Seven years of healthcare experience in regulatory compliance with provider network regulations and application to managed healthcare organizations, network management or regulatory network reporting requirements, with provider data repositories, in data analysis, reporting, and the use of data software used for network assessment and reporting such as Quest Analytics, Power BI, or Tableau, and/or strong analytical skills interpreting complex data and decision making to improve network access
  • Or an associate degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND five years of healthcare experience in regulatory compliance with provider network regulations and application to managed healthcare organizations, network management or regulatory network reporting requirements, with provider data repositories, in data analysis, reporting, and the use of data software used for network assessment and reporting such as Quest Analytics, Power BI, or Tableau, and/or strong analytical skills interpreting complex data and decision making to improve network access
  • Or a bachelor's degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND three years of healthcare experience in regulatory compliance with provider network regulations and application to managed healthcare organizations, network management or regulatory network reporting requirements, with provider data repositories, in data analysis, reporting, and the use of data software used for network assessment and reporting such as Quest Analytics, Power BI, or Tableau, and/or strong analytical skills interpreting complex data and decision making to improve network access
  • Or a master's degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND one year of healthcare experience in regulatory compliance with provider network regulations and application to managed healthcare organizations, network management or regulatory network reporting requirements, with provider data repositories, in data analysis, reporting, and the use of data software used for network assessment and reporting such as Quest Analytics, Power BI, or Tableau, and/or strong analytical skills interpreting complex data and decision making to improve network access
  • Two years of supervisory experience or seven years as a lead with responsibility for training others
Preferred Qualifications
  • Working toward or have an industry-specific designation, such as Certified Health Data Analyst (CHDA), Registered Health Information Technician (RHIT)
  • Experience drafting, analyzing, researching, or applying provisions of provider and facility contracting
  • Expert level Microsoft Excel skills
  • Experience analyzing, researching, or applying the Affordable Care Act (ACA)
How to Apply

Applications for this recruitment will be accepted electronically. Please select the large green apply button at the top of this announcement. If you have not done so previously, you will need to set up an account profile. Please provide three professional references on your application. A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies. If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.



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