Management Analyst 1

State of Nevada•Carson City, NV

About The Position

The Public Employees’ Benefits Program (PEBP) Quality Control Unit within the Nevada Health Authority is seeking a Management Analyst 1 in Carson City. The position serves as a Quality Control Specialist supporting the review and resolution of member complaints, grievances, and appeals related to health benefits, claims, and program services. The role reviews incoming cases, identifies the issues raised by members, gathers and verifies relevant information, researches applicable benefit provisions and established procedures, and documents findings. It assists in evaluating whether claims, benefits, and member concerns have been handled appropriately and in accordance with PEBP Master Plan Documents (MPDs), applicable administrative codes, and program policies. The Quality Control Specialist maintains case records, tracks case progress and deadlines, follows up on outstanding information, and assists with preparing written responses and case summaries. The position also helps identify discrepancies, recurring issues, and opportunities to improve processes, accuracy, and consistency in handling member concerns. This is an entry-level analytical role requiring sound judgment, attention to detail, professional communication, confidentiality, and a willingness to learn. The successful candidate will develop knowledge of health benefits administration, claim review, appeals procedures, policy interpretation, and quality control practices while working under established guidelines and supervisory direction. Management Analysts conduct studies, research, and examination of management and administrative areas such as agency operations, forms, policies and procedures, workflow, legislative analysis, management research, and statistical and informational analysis.

Requirements

One or more years of applicable experience as described in the job duties.
Graduation from high school or equivalent education.
Sound judgment, attention to detail, professional communication, and confidentiality.
Knowledge of research and analysis techniques and methodologies.
Knowledge of management and administration concepts, principles, and practices.
Knowledge of evaluating, developing, and recommending administrative and/or operational policies and procedures.
Interpersonal and communication skills, both verbal and written.
Skill in using and operating office and job-related equipment and software.
Ability to compose business correspondence and reports.
Ability to analyze information, problems, or practices to identify relevant concerns, patterns, tendencies, and relationships, and formulate logical conclusions.

Responsibilities

Review incoming member complaints, grievances, and appeals; identify the issues raised.
Gather and verify relevant information, research applicable benefit provisions and established procedures, and document findings.
Assist in evaluating whether claims, benefits, and member concerns have been handled appropriately in accordance with PEBP Master Plan Documents, applicable administrative codes, and program policies.
Maintain case records, track case progress and deadlines, and follow up on outstanding information.
Assist with preparing written responses and case summaries.
Help identify discrepancies, recurring issues, and opportunities to improve processes, accuracy, and consistency in handling member concerns.
Conduct research and analyze legislative implications.
Determine software application program needs or requirements.
Review and monitor contracts.
Make recommendations on policy and procedure improvements.
Provide recommendations to management regarding programs and/or work unit activities.
Prepare reports and correspondence.
Perform related duties as assigned.