Provider Network Analyst

Profile

We have an opportunity to join the Alliance as a Provider Network Analyst within the Provider Services Department. We are filling one position, in any Alliance office: Merced, Salinas or Scotts Valley. Interested candidates need to submit one application only.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Quality and Network Development Manager, you will:

Lead and support provider network evaluation and reporting

Initiate, coordinate, and analyze the results of provider network surveys and ensures

compliance with regulatory standards

Coordinates regulatory reporting, the submission of audit-related deliverables, and policy review

THE IDEAL CANDIDATE

You are analytical, and comfortable and proficient in Microsoft Excel, including creating pivot tables and using VLOOKUP

You are organized and thrive in managing deliverables and deadlines

You are comfortable writing business summaries and making presentations to leadership

Experience performing provider network development, evaluation, analysis, and related reporting

Some knowledge of provider networks in Santa Cruz, Monterey and Merced counties

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here

Knowledge of:

Research, analysis and reporting methods

Healthcare industry and the principles of healthcare planning

California Medi-Cal program

Principles and practices of project management

Windows-based PC systems and Microsoft Word, Outlook, Excel, and PowerPoint

Ability to:

Identify issues, conduct research, analyze and interpret data, reach logical and sound conclusions, and make recommendations for action

Interpret policies, procedures, standards and guidelines

Manage multiple projects simultaneously, create project plans, organize work, identify and involve relevant stakeholders, and achieve goals and timelines

Understand, interpret and apply complex legislative and regulatory directives, policies, standards, and guidelines

Create datasets and build reports from datasets

Education and Experience:

Bachelor’s degree in Business, Public Administration, Economics, Healthcare or a related field

A minimum of five years of experience in a managed care environment which included a minimum of three years of experience related to data analysis and/or regulatory reporting (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER DETAILS

While this position is connected to one of our Alliance offices, we are in a fully telecommute work environment right now due to the COVID-19 pandemic. The interview and on-boarding process for this position will be completed remotely

This position

may

require onsite presence when our offices re-open. Onsite presence will most likely be on a part-time basis, but is dependent on business needs

COVID-19 Vaccine Requirement:

At this time, this position requires vaccination or regular testing upon office entry. Fully vaccinated is defined as receipt of the second dose in a 2-dose series (ex: Pfizer & Moderna vaccines) OR receipt of a single-dose vaccine (ex: Johnson & Johnson); AND receipt of the booster (if eligible); AND a 2-week period having passed since the administration of the last vaccine dose. If you state that you are vaccinated, proof of vaccination must be submitted at time of hire.

Additionally, all positions at the Alliance are required to meet these minimum qualifications

OUR BENEFITS

Medical, Dental and Vision Plans

Ample Paid Time Off

11 Paid Holidays per year

401(a) Retirement Plan

457 Deferred Compensation Plan

Robust Health and Wellness Program

EV Charging Stations

And many more

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 377,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Company info

Central California Alliance for Health
Website : http://www.ccah-alliance.org/