Senior Network Analyst Lead
2 days ago
Job Overview
We are seeking an experienced Senior Network Analyst Lead to join our team at Point32Health. This is a dynamic opportunity for a strategic thinker with advanced analytical and problem-solving skills to lead cross-functional teams in developing, negotiating, monitoring, and reporting of contractual agreements with healthcare providers.
Key Responsibilities
- Reporting and Analytics - Design and generate various reports and financial analytics that focus on medical cost, utilization, membership, trends, and ad hoc requirements. Present actionable information to identify trend drivers and opportunities for improvement in Point32Health and provider performance.
- Cost Avoidance and Recovery - Work independently to identify and present cost avoidance and recovery opportunities.
- Financial and Utilization Analytics - Perform financial and utilization analytics required by other departments within Point32Health, including Medical Management, Contracting, Payment & Policy, etc.
- Reimbursement Strategies - Utilize in-depth understanding of reimbursement methodologies and trends in managed care finance to lead the development and analysis of new reimbursement strategies and financial analytics supporting provider contracting in the Point32Health network.
- Communication and Project Management - Responsible for ongoing communication with customers, providing project status, resolving issues, coordinating continued involvement to meet original expectations or jointly agreed-upon adjusted expectations.
Requirements
- Bachelor's degree in Business Administration, Finance, 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, health care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment.
- Strategic thinker with strong analytic and problem-solving skills, and ability to work in a team environment.
Benefits
- Competitive salary: $120,000 - $150,000 per annum.
- Comprehensive total rewards package, including medical, dental, and vision coverage, retirement plans, paid time off, employer-paid life and disability insurance, tuition program, and well-being benefits.
About Us
Point32Health is a leading health and wellbeing organization delivering personalized healthcare experiences to communities nationwide. We leverage our expertise and heritage to help people find healthier living through diverse health plans and tools that simplify navigating health and wellbeing.
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