Analyst 1 – Provider Services

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  • 18-00271
  • Full Time/Contract
  • Provider Relations
  • Rancho Cucamonga, CA
Job Description
CLIENT COMPANY OVERVIEW
Our Client is a not-for-profit, rapidly growing Medi-Cal and Medicare health plan serving over 1,138,447 residents of the Riverside and San Bernardino counties. Our client maintains a Positive Team Culture as demonstrated by being voted by Los Angeles News Group readers as "Favorite Overall Company to Work For,” "Favorite Training Program” and "Favorite Workplace Culture” in their 2014 Winning Workplaces survey.

JOB TITLE
Analyst I – Provider Services

DESCRIPTION
Under the general supervision of the Provider Services Administrative Manager, the Business Analyst will assist in the design and structure of the Provider Services Department Training Program. Responsibilities include: assist in implementing and managing all training activities for the Provider Services Department; identify, maintain and manage the provider website for continuous support and evaluation including analysis of the current system/software and customer needs effectively. The position will also be responsible for variety of complex assignments that are delegated by Management in terms of objectives rather than specific instructions. The BA is responsible for supporting the Manager in all required or directed activities.

1. Act as an assistant to the Provider Services Administration Manager as follows:
a. Coordinate all department functions as requested.
b. Act as liaison between the department and other Company departments.
c. Prepare special reports and develop department reporting needs.
d. Assist in drafting and writing communications to Providers.
f. Management and upkeep of the Provider Contact information database.
g. Assist on special projects new software applications or enhancements to existing applications including testing and validation prior to implementation.
h. Provide web related technical and business support.
2. Assist in the development and production of internal and external policies and procedures and ensure compliance with NCQA, State and Federal regulations.
3. Responsible for writing training materials, working in a team setting with other Provider Service team members as well as subject matter experts within Company to develop new training materials and enhance existing resources.
4. Assist in the development of communications strategy, testing, creation of business rules and training tools for new software application projects that include Referrals, Authorizations, Claims and/or any provider online submissions applications. Responsible for the compilation of data, and information analysis.
5. Participation in Lean Events.
6. Develop systems and processes to support operational strategies and needs.
7. Requires general knowledge of concepts, practices and procedures within a specified field.
8. Analyze requirements for custom reports and operational processes.
9. Any other duties as required to ensure Health Plan operations are successful.
10. Ensure the privacy and security of PHI (Protected Health Information) as outlined in Company's policies and procedures relating to HIPAA compliance.

SKILLS & QUALIFICATIONS

Possession of a Bachelor's degree from an accredited institution required.
 
1-2 years experience in Training preferred. Ability to multi-task, prioritize and stay organized in an ambiguous work environment. Ability to work with minimal direction. Prior office experience or experience in a managed care environment preferred.
 
Requires general knowledge of concepts, practices and procedures within a specific field. Ability to research and analyze data and make sound recommendations. Strong verbal and written communication skills required with advanced knowledge of micro computer applications.

COMPENSATION | POSITION CLASSIFICATION

  • $23.65 – $27.84
  • Temporary Contract

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