Provider Network Analyst (FPA3 - 4 positions)

This recruitment will remain open until September 25, 2024. The agency reserves the right to make a hiring decision at any time after the initial screening date on September 09, 2024. It is in the applicant’s best interest to submit materials as soon as possible.
 
OIC CAREER OPPORTUNITY
 
The Office of the Insurance Commissioner (OIC) is seeking a four (4) motivated and qualified individual to fill Provider Network Analyst (Functional Program Analyst 3) positions.  These positions are assigned to the Rates, Forms, and Provider Networks Division, located in our Tumwater office.
 
These professional-level positions are responsible for independently performing analytical reviews, and evaluations of the healthcare provider networks, evaluating complaints related to potential network access gaps, and identifying contractual compliance issues with Washington State and federal insurance laws, including the Affordable Care Act (ACA) in support of the OIC’s mission to protect consumers and the public interest.
 
What are we looking for?
 
We are looking for individuals who understand there is no “I” in TEAM. We are interested in someone who is comfortable working independently, proficient in the specific skills required for the role, able to handle change and adjust to new challenges, competent in identifying issues and devising effective solutions, proactive in taking on tasks and going beyond the minimum requirements, demonstrates reliability, responsibility, and a strong commitment to their work, able to maintain positive working relationships and has effective communication skills, and able to prioritize tasks and meet deadlines effectively.
 
What’s in it for you?
 
The successful candidates would be joining a team with a supportive leader and team. The work that will be performed is a new area of insurance regulation. Washington is a leader in this topic and other states are looking at what/how we are addressing regulatory issues. Joining this team means you get to be apart of this groundbreaking and evolving insurance topic.

If you're interested in a dynamic career that protects consumers' interests and promotes a healthy business environment in this state, please apply and become part of our dynamic team.
 
This recruitment may be used to establish a qualified pool of candidates for Functional Program Analyst 3 vacancies in the next sixty days.
 
This is a Washington General Service position. The monthly salary range for this position is $4,987 - $6,705.
 
AGENCY PROFILE AND VALUES

The Office of the Insurance Commissioner (OIC) operates under the direction of the state's Insurance Commissioner, a statewide elected official. Our mission is to provide consumer protection and regulation of the state's insurance industry.
 
With a workforce of approximately 265 employees, we are one of the smaller state agencies in Washington state government and are fortunate to have a stable funding source that does not rely on the state's general fund.
 
Because we are a small agency, you will truly get a chance to understand the 'big picture' of what we do and why we do it. You will also have a chance to get to know your co-workers.
 
We value diversity in the workplace. We challenge our employees to continuously improve the way we do business and to meet and exceed the needs of our customers.
 
To learn more about this agency, we invite you to visit our website at http://www.insurance.wa.gov/ and listen to our employees talk about why they love working here. 
 
BENEFITS OF WORKING FOR OIC

Washington State offers one of the most competitive benefits packages in the nation. We offer a great selection of health and retirement plans, paid leave, and compensation benefits for you and your family.
 
Additional Benefits:
 

• Wellness programs.
• Dependent care assistance.
• Washington State Employee Assistance Program.
• Federal Social Security and Medicare systems.
• Additional Leave; Leave Sharing, Parental Leave, Family and Medical Leave Act (FMLA), Leave Without Pay.
• Deferred Compensation (supplemental retirement plan).
• Training and development opportunities, including tuition reimbursement.
• Program for Public Service Loan Forgiveness (if applicable)
• Free parking at our main office in Tumwater.
• A stable funding source that does not rely on the state's general fund.
• The fulfillment of public service.
• Excellent work-life balance.
• Flexible work schedules and telework opportunities.
• Commitment to diversity in the workplace and support one another with respect and trust.
• Free Thurston County Transit public transportation.

Duties

The duties of the position include, but are not limited to: 
 

• Reviewing network access reports to create trend analyses and summaries for decision-making purposes.
• Reviewing provider organizations and systems for development of analysis that supports the program.
• Communicating issues about compliance concerns with reporting and data quality with insurance companies and/or their third-party filers.
• Reviewing and researching consumer inquiries and referrals to provide information and/or potential recommendations for corrective action.
• Presenting findings of fact in report form.
• Performing multi-layer, integrated analysis of network access templates.
• Participating as a team member on the binder team.
• Using CMS tool resources to review binder data files for compliance.
• Providing written instructions and guidance to filers regarding objectionable issues with the documents.

Required Qualifications: 
 
Six (6) years of experience working in the healthcare, insurance or regulatory field interpreting, analyzing, or reports on statutory requirements through a combination of any of the following:
 

• Completion of a degree (associate degree = 2 years, bachelor’s degree = 4 years, and so on.); and/or
• Ensuring compliance with governmental statutory and insurance, or other regulatory requirements; and/or
• Professional work with Health & Disability insurance, Self-funded plan, or Provider Relations; and/or
• Experience related to healthcare claims payment configuration, credentialing, or utilization process/systems and the relevance on network operations impact; and/or
• Experience analyzing data using business intelligence software and creating data visualization reports for a variety of audiences.

The degree must be from an accredited institution whose accreditation is recognized by the U.S. Department of Education or the Council of Higher Education Accreditation or a foreign equivalent.
 
AND
 

• Intermediate level Microsoft Office Outlook, Word, and Excel skills.

 
Preferred/Desired:
 

• 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 the provisions of provider and facility contracting.
• Intermediate level Microsoft Power BI skills with the ability to create reports, extra data designs, and edit reports.
• Previous healthcare analytics experience directly assisting in preparation of monthly, quarterly, and annual data reports for state or federal reporting for assuring compliance with healthcare statutory requirements such as Title X, Medicaid, or Medicare.