Network Management Analyst - 33080ES - Walnut Creek or Sacramento, CA

WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide.Anthem Blue Cross is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to our mission of improving the health of the people we serve. We believe the best health care coverage can actually help people stay healthy. Bring your expertise to our innovative, performance-focused culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine. Network Management Analyst - 33080ESLocation: Walnut Creek or Rancho Cordova, CAYou’ll play a critical role in providing analysis and project support for several innovative programs focused on optimizing the efficiency and quality of care delivered to our members.  A primary focus for 2008 includes a newly introduced joint program with our Medical Groups focusing on the proper and effective management of facility services.  You will be responsible for tracking the progress of our groups under this program and identifying new opportunities to further improve performance. You will also support the annual analysis and evaluation of our HMO and PPO special networks, including Power Advantage and Power Select HMO networks.   As a member of the health care management team, you will work closely with our provider contracting staff, and medical directors.  And you will be available to answer questions and provide support directly with our Medical Groups as needed.You should be seasoned in both data analysis and project management support, and be comfortable working in a fast paced environment where creative ideas and a passion for making a difference are a core part of our values.   You will be responsible for working in a consultative and strategic role with health care management staff in the areas of compliance, contract language, contracting processes, systems functionality and implementation, and provider reimbursement audits with specific accountability on reducing administrative expenses and cost of care. Specific requirements include managing large quantities of data from various corporate systems and external sources to prepare network reports, analyses, and databases.  Developing database structures and reports.  Reviewing  provider organizations and systems for development of analyses that support the contract negotiation process and improvements in cost of care.  Interfacing with internal and external business partners to obtain information for network reporting and analysis.  Participating in the planning and implementation of multidisciplinary work groups as needed for project oversight and support.  Developing project plans and schedule.  Coordinating  and implementing departmental or corporate initiatives.  Conducting market research related to narrow networks and high performance provider networks. Conducting complex analysis and interpretation of network and membership data to ensure appropriate reports for decision making are generated accurately and as scheduled.  Responsible for ensuring those database structures are established.  Responsible for researching provider organizations and systems for the development of recommendations related to contract negotiation process and network design opportunities.  Working with complex statistical and financial data to develop reports and findings on competitive practices related to provider services.  Working on assigned areas related to the development and integration of provider networks.  Working on special projects to develop, coordinate and implement departmental and/or corporate initiatives.  WellPoint is ranked No. 1 among health insurers on Fortune Magazine’s annual list of America’s Most Admired Companies and has been named as one of the Top 50 Companies for Diversity by DiversityInc Magazine. To learn more about our company please visit us at www.anthem.com.BA/BS degree required. MBA or MHA preferred. 7-10 years provider contracting experience required. Excellent quantitative, analytical and problem solving skills required. Excellent oral and written communication skills required. Has strong business and operational knowledge of healthcare delivery system and/or network development and management. 2-4  years of analytical or project management experience required. Knowledge of MS Office, specifically Excel, Access and Project or similar software required. 2-3  years experience in health care administration and a clear understanding of health plan operations required.