Senior Network Analyst Lead

7 days ago


Canton, Ohio, United States Point32Health Full time
About Us

At Point32Health, we are committed to delivering an ever-better personalized healthcare experience to everyone in our communities. Our organization is built on the quality, nonprofit heritage of Tufts Health Plan and Harvard Pilgrim Health Care.

Job Summary

We are seeking a Senior Network Analyst Lead to join our team. This role will be part of a team responsible for developing, negotiating, monitoring, and reporting contractual agreements with healthcare providers and institutions.

Key Responsibilities
  • Design and generate various reports and financial analytics focusing on medical cost, utilization, membership, trends, and ad hoc requirements.
  • Create actionable information based on detailed analytics to identify trend drivers and opportunities for improvement in Point32Health and provider performance.
  • Work independently to identify and present cost avoidance and cost recovery opportunities.
  • Perform financial and utilization analytics required by other departments within Point32Health.
  • Lead the development and analysis of new reimbursement strategies and financial analytics supporting provider contracting in the Point32Health network.
Requirements
  • Bachelor's degree in Business Administration, Finance, or Health Services required; Master's preferred.
  • 5-7 years of business experience, preferably in managed care or provider environment.
  • Advanced Excel skills; proficiency with SAS/SQL programming required.
  • In-depth knowledge and understanding of managed care concepts and the financial relationship between payers and providers.
  • Solid knowledge of healthcare claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment.
  • Strong analytical and problem-solving skills.
  • Strong interpersonal and collaboration skills.
Estimated Salary Range: $120,000 - $160,000 per year

This estimate is based on national averages and may vary depending on location, experience, and other factors.

Total Rewards Package

We offer a comprehensive total rewards package including:

  • Medical, dental, and vision coverage
  • Retirement plans
  • Paid time off
  • Employer-paid life and disability insurance with additional buy-up coverage options
  • Tuition program
  • Well-being benefits

Please note that this job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to equal opportunity and equal treatment for every prospective and current employee.



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