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Provider Relations Analyst, Camarillo, CA


Organization: Gold Coast Health Plan
Category: Professional
Location: Camarillo, CA
Date Job Posted: August 29, 2022
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Provider Relations Analyst

Professional
Camarillo, CA, US

Requisition ID: 1321

POSITION SUMMARY

The Analyst, Provider Relations, is responsible for preparing and analyzing various standard and ad hoc reports and decision support tools for management. The Analyst, Provider Relations, is also responsible for analyzing, developing, and implementing database designs, data models and relational database definitions across multiple computing environments under general supervision.

Interacts with various departments to ensure appropriate data is developed, maintained and used appropriately throughout Gold Coast Health Plan. The position is also responsible for supporting Provider Relations with assigned projects, development of policies, procedures and workflows, systems management and organization.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s)

  • Identify, analyze, and interpret trends or patterns for methods to better benefit the Plan.
  • Develop and maintain databases necessary for projects and department functions.
  • Uses analytical and data skills to produce reports to support the Business in making data driven business decisions.
  • Develop graphs, adhoc and regularly schedule reports, and presentations of project results.
  • Reviews data to ensure validity.
  • Perform basic statistical analyses for projects and reports.
  • Performs basic analyses on departmental productivity.
  • Extract and analyze data from various sources to achieve cost saving programs for the Plan.
  • Generate routine and ad hoc reports as assigned.
  • Perform provider network analysis, trending reports and provider access data.
  • Facilitates provider satisfaction surveys as related to how they affect provider satisfaction.
  • Maintains an uptodate and thorough knowledge of Gold Coast Health Plan's policies as related to provider contracting and operations.
  • Provides accurate research to resolve issues regarding, claims and contracting using appropriate systems.
  • Properly documents all calls/contacts as required by department standards in a clear and concise manner.
  • Communicates complex issues effectively to both internal and external business associates.
  • Supports Manager, Provider Network.

POSITION QUALIFICATIONS

Competency Statement(s)

  • Analytical Skills - Ability to use thinking and reasoning to solve a problem.
  • Technical Aptitude - Ability to comprehend complex technical topics and specialized information.
  • Business Acumen - Ability to grasp and understand business concepts and issues.
  • Presentation Skills - Ability to effectively present information publicly.
  • Customer Oriented - Ability to take care of the customers’ needs while following company procedures.
  • Relationship Building - Ability to effectively build relationships with customers and co-workers.
  • Diversity Oriented - Ability to work effectively with people regardless of their age, gender, race, ethnicity, religion, or job type.

SKILLS & ABILITIES

Education: Bachelor's Degree (four year college or technical school) Required, Field of Study: Information Management.Systems, Finance/Accounting, Healthcare Information.

Or Bachelor's Degree in related fields: Business, Computing, Mathematics, Statistics, or related technical/analytical fields. Preferred.

Experience: Previous data analyst experience.

Healthcare background or experience a plus.

Computer Skills: Proficient in MS Word, Excel, Access, and PowerPoint.

Certifications & Licenses:

A valid California Driver's License and insurance.

Other Requirements: Technical expertise regarding data models and database design development.

Adept at queries and report writing.

Strong business analysis, mathematical, statistical, and data analysis skills. Research, analytical, organization, and time/project management skills required. Knowledge of statistics, to the degree one can discuss with statisticians.

Excellent analytical ability, judgment and problem solving.

Ability to present complex information in an understandable and compelling manner. Communicate effectively in both verbal and written form.

Professionalism - Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position; accepts responsibility for own actions; follows through on commitments.

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