Provider Services Analyst

Health Net, Inc. is a publicly traded managed care organization that delivers managed health care services through health plans and government-sponsored managed care plans. Its mission is to help people be healthy, secure and comfortable.

The Provider Services Analyst is responsible to lead and coordinate cross-functional teams to facilitate collaboration, coordination and engagement of appropriate business areas for assigned initiatives/projects. Responsibilities also include developing and conducting associate training; development, implementation, completion, and maintenance of assigned Provider Services Operations initiatives; and, ongoing monitoring, tracking and reporting to management for assigned initiatives/projects.

- Lead/coordinate cross-functional teams to facilitate collaboration, coordination and engagement of appropriate business areas for assigned initiatives/projects. Identifies and documents business needs and objectives, current operational procedures and gaps, and recommends operational and process improvements. May involve user acceptance testing for those projects with Provider Services impact. - Develop, monitor, track, and manage project plans, including regulatory filing project plans, including goals, strategies, tasks, and meeting timelines for assigned initiatives. - Ensure compliance with Health Net processes, and regulatory and legislative requirements related to Provider Network Management and contracting providers (First Tier and First Tier's Downstream Entities) for the Western Region by performing regular monitoring, tracking and reporting to management on all assigned compliance metrics. Responsibilities include development, implementation, monitoring, tracking, reporting, and closure of any corrective action plans needed for any compliance deficiencies. Responsibilities include leading or participating in compliance audits related to Provider Network Management and contracting providers for the Western Region. - Develop and conduct associate training or communication to PNM associates relative to operations' initiatives and process improvement. Provide education outreach to associates and contracting providers when identified. - Perform other duties as assigned.

**Education:** * Bachelor's Degree preferred **Certification/Licensure Required:** * N/A **Government Clearance & US Citizenship Requirement:** * May require US citizenship and current security clearanceN/A **Experience Required** - Three to five years experience in provider relations, provider contracting, health plan operations or health care/medical office environment - Prior work experience in Insurance Industry, and/or Health Care industry preferred - Customer Service experiences a plus - Experience in Health Care administration or related field **Knowledge, Skills & Abilities** - Strong analytical and problem-solving skills, customer focus, and expeditious follow-up skills - Outstanding communication skills including excellent verbal, written, and presentation abilities - Ability to prioritize and multi-task while paying attention to detail and meeting tight deadlines - Proficient in Microsoft office (Word, PowerPoint and Excel) **Working Conditions** - The following section describes the general physical requirements for this position. Please note that constant refers to more than 81% of time; significant refers to 40-80%; and moderate refers to 20-40% of the time. - Operates personal computers, printers, facsimile, telephones, copy machines and other commonly used office accessories/equipment. - Exposed to confidential information and expected to maintain confidentiality at all times; must adhere to HIPAA rules and regulations. - May be required to work outside of normally scheduled hours as mandated by the client, project and/or workload (e.g. evenings, weekends, and/or holidays). - May be required to maintain established work pace, meet deadlines; may have last minute urgent requests. - Physical activity may include: twisting, reaching, kneeling, bending, stooping, squatting, crawling, grasping, grabbing, pushing, pulling, repetitive motion, climbing, etc. - Required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned. - Required to have hearing ability to receive detailed information through oral communication. - Required to have speaking ability to express or exchange ideas. - Constant concentration may be required on various subjects by listening, reading and thinking clearly. - Interaction with others may be required. May need to listen, think, and speak in order to interact with others. Business interactions and behavior between coworkers and/or external customers are required. This may require face-to-face or telephone interactions. - Thinking at work may include listening, learning, analyzing, evaluating, and the ability to interpret what is seen and/or heard, or to link information from one issue to the next. - Constant computer usage including typing and/or eye strain. - Constant repetitive arm, wrist, hand and finger motions -- making repetitive movements (e.g. key boarding, filing, data entry). - Moderate phone usage; headsets may be required. - Significant sedentary work (desk bound or seated). - Significant reading is required via computer screen and/or bound printed materials.