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Senior Provider Network Analyst

1 month ago

Olympia, Washington, United States State of Washington Full time
About the Role

We are seeking a highly skilled and experienced Senior Provider Network Analyst to join our team at the Office of the Insurance Commissioner. As a key member of our Provider Network Oversight Program, you will play a critical role in ensuring the timely, consistent, and accurate independent analysis, evaluation, and approval or disapproval of state-wide 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/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 health care system, geographic barriers, and the legal requirements.
Requirements
  • Seven (7) 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.
  • Option 2: An associate degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND five (5) 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.
  • Option 3: A bachelor's degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND three (3) 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.
  • Option 4: A master's degree in healthcare administration, business administration, public health, or a health-related field, law, or closely related field AND one (1) 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.
  • AND Two (2) years of supervisory experience or seven (7) years as a lead with responsibility for training others.
Preferred Qualifications
  • Intermediate level Microsoft Office Word and Excel skills.
  • 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 (3) 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.

The initial screening will be based on the content and completeness of your application and the materials submitted. All information may be verified, and documentation may be required. Your letter of interest should describe how your experience, training, and education make you a viable and competitive candidate for this position. Applications with comments such as "see attachments" or "see resume" in the supplemental question responses will be considered incomplete.

General suggestions for creating a good application:

  • Read the job posting very carefully. Find out as much as you can about the position.
  • Make sure you are very diligent in following all the application instructions.
  • Include all requested documentation.
  • Make sure your application and supplemental question responses address how you meet each of the required and desired qualifications.
  • Carefully read each of the supplemental questions and respond completely to each one. Pay attention to each component of the question, providing examples, and thoroughly describing when and where you achieved the experience. Detail the types of work you performed, the work products, etc., to demonstrate 'how'.
  • Specifically include all your work experiences doing the same or similar work, especially if you reference work in these jobs in describing when/where you gained experience or skills.
  • Make sure your application reflects your best writing.

Wage/salary depends on qualifications or state rules of compensation (if currently a state employee).

Contact us: For inquiries about this position, please contact Treese Beckett at.

Other Information:

  • This position is represented by the Washington Federation of State Employees (WFSE).
  • State law (RCW 48.02.090[5]) prohibits employees of the OIC from having any interest, directly or indirectly, in an insurance company other than as a policyholder. This prohibition includes the receipt of renewal commissions. If employment is accepted with this agency, you agree to abide by this state law.
  • If a degree or other credentials are listed by the candidate, proof will be required at the finalist stage. Candidates are encouraged to pre-plan for this.
  • University degrees must be recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA) or foreign equivalent.
  • If a degree was awarded outside the United States, candidates must provide a credential evaluation report.
  • Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position.
  • If claiming veteran status, please send your DD 214 to with DD214_in the subject line. Please do not attach the DD 214 to your application materials.
  • Please black out personally identifiable data such as social security numbers.
  • The Office of Insurance Commissioner is an equal opportunity employer. Auxiliary aides and services are available upon request to individuals with disabilities. Please contact the recruiter listed above.
  • If you are having technical difficulties creating, accessing (log in, password or email issues) or completing your application (error messages), please call toll-free at (855).
  • For general questions regarding applying for jobs, contact the recruiter or.