Job Description
DESCRIPTION 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 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:
- 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.
QUALIFICATIONS 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.
SUPPLEMENTAL INFORMATION How to Apply : Applications for this recruitment will be accepted electronically. Please select the large green "apply" button at the top of this announcement. If you have not done so previously, you will need to set up an account profile.
Please provide three (3) professional references on your application. A professional reference is defined as an individual who has been paid to supervise your work and can attest to your work performance, technical skills, and job competencies. If you do not have any or sufficient professional references, please include non-related professionals, such as educators or other professional associates.
The
initial screening will be based on the content and completeness of your application and the materials submitted. All information may be verified, and documentation may be required. Your letter of interest should describe how your experience, training and education make you a viable and competitive candidate for this position. Applications with comments such as "see attachments" or "see resume" in the supplemental question responses will be considered incomplete.
General suggestions for creating a good application:
- Read the job posting very carefully. Find out as much as you can about the position.
- Make sure you are very diligent in following all the application instructions. Include all requested documentation.
- Make sure your application and supplemental question responses address how you meet each of the required and desired qualifications.
- Carefully read each of the supplemental questions and respond completely to each one. Pay attention to each component of the question, providing examples, and thoroughly describing when and where you achieved the experience. Detail the types of work you performed, the work products, etc., to demonstrate 'how'.
- Specifically include all your work experiences doing the same or similar work, especially if you reference work in these jobs in describing when/where you gained experience or skills.
- Make sure your application reflects your best writing.
Wage/salary depends on qualifications
or state rules of compensation (if currently a state employee).
Contact us : For inquiries about this position, please contact Treese Beckett at recruitment@oic.wa.gov .
Other Information: - This position is represented by the Washington Federation of State Employees (WFSE).
- State law (RCW 48.02.090[5]) prohibits employees of the OIC from having any interest, directly or indirectly, in an insurance company other than as a policyholder. This prohibition includes the receipt of renewal commissions. If employment is accepted with this agency, you agree to abide by this state law.
- If a degree or other credentials are listed by the candidate, proof will be required at the finalist stage. Candidates are encouraged to pre-plan for this. University degrees must be recognized by the U.S. Department of Education and the Council for Higher Education Accreditation (CHEA) or foreign equivalent.
- If a degree was awarded outside the United States, candidates must provide a credential evaluation report.
- Prior to a new hire, a background check including criminal record history will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant’s suitability and competence to perform in the position.
- If claiming veteran status, please send your DD 214 to recruitment@oic.wa.gov with FPA3_2024-09827 in the subject line. Please do not attach the DD 214 to your application materials. Please black out personally identifiable data such as social security numbers.
- The Office of Insurance Commissioner is an equal opportunity employer. Auxiliary aides and services are available upon request to individuals with disabilities. Please contact the recruiter listed above.
- If you are having technical difficulties creating, accessing (log in, password or email issues) or completing your application (error messages), please call toll-free at (855) 524-5627.
- For general questions regarding applying for jobs, contact the recruiter or careershelp@des.wa.gov .
Job Tags
Full time, Work experience placement, Remote job, Flexible hours,