Network Review Analyst

About the role

The incumbent is assigned program-related responsibilities that ensure effective interpretation and implementation of the Knox-Keene Health Care Service Plan Act of 1975 (Act), the California Code of Regulations, title 28 (Regulations) and program policies and procedures.

Responsibilities

• Perform duties involved in planning, implementing, monitoring and evaluating health program activities within the OPM.
• Provide analytical support for the review and evaluation of health care service plan licensing filings and data from various network review projects.
• Use computer software (e.g., Excel, Access, Word and geographic access software) to analyze and display data, develop reports and present information at meetings.

Qualifications

The position requires a Background Investigation be cleared prior to being hired.

Skills

• Knowledge of health care service plan programs and trends.
• Knowledge of provider networks.
• Work proficiently on spreadsheets and database files using Microsoft Excel, Access Database and Word applications.
• Experience gathering, analyzing and organizing data to make recommendations on program issues.
• Experience in managed health care.
• Ability to organize and establish simultaneous workload priorities and work under pressure.
• Experience in creating Accessible Documents (PDF, Excel, WordDoc).
• Ability to work independently and in a team environment.
• Exercise a high degree of initiative and confidentiality.
• Ability to professionally communicate both orally and in writing.
• Ability to reason well and use good judgment.
• Dependable, punctual and excellent attendance.

Benefits

The position does not specify any benefits.

Pay

$6,031.00 - $7,547.00 per Month

Schedule

The position does not specify a schedule.