Point32Health

Healthcare

Director,Network&ProviderAnalytics

$160–241k Canton, Massachusetts, United States FULL TIME Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Director candidates.

The Brief

“Director, Network & Provider Analytics at Point32Health. Skills: Network analytics, Provider analytics, Financial modeling. Identify and oversee development of analyses, models, and. Offer informed view of provider, network, and contract”

What You'll Achieve.

Deliver relevant and meaningful financial analyses; Achieve goals

Industry & Context.

Healthcare
Problems you'll solve

Synthesize financial information; Create options; Evaluate options

Eligibility Requirements

Work from home, Additional hours

What They're Looking For.

Must Have

Bachelor's degree in business, health administration, or finance, 10-15 years of progressive analytic, financial, project, or operational experience in healthcare, 3+ years of effective supervisory experience, In-depth knowledge of managed care concepts, Solid knowledge of health care claims data, Solid knowledge of coding schemes, Solid knowledge of health status risk adjustment, Proven ability to work effectively across all levels of the organization

Nice to Have

Master's degree preferred, 10-15 years of experience in healthcare analytics, provider network management, or related field, Background in data analysis and leadership roles, Previous experience director-level position

What You'll Do.

Identify and oversee development of analyses

Offer informed view of provider

Formulate and execute strategies to improve unit cost

Standardize reimbursement methodologies

Maintain competitive provider networks

Provide direction and define approach for reimbursement strategy

Define parameters for payment methodologies

Oversee development of provider rates

Oversee submission of regulatory submissions and requests

analyze and report on competitive position

Produce accurate and timely reporting on network access

Ensure standards are maintained

Address gaps appropriately

Engage with Sales team to provide information and

Participate as subject matter expert in meetings

Represent Provider Partnerships organization in governance forums

Provide thought leadership

Express business needs

Manage relationships with key internal constituencies

Ensure team adheres to enterprise data and analytics

Ensure team adheres to policies and procedures

Coach staff in analytics

Support staff in analytics

Coach staff in leadership

Support staff in leadership

Coach staff in relationship management

Support staff in relationship management

Enable a high-performing team

Perform other duties and projects as assigned

How You'll Work.

Team & Collaboration

Matrix environment; Cross-departmental meetings; Enterprise governance forums; Internal constituencies

Communication Scope

Verbal communication; Written communication; Subject matter expert

Full Job Description

**Who We Are** Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We’ve had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it’s at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about [who we are at Point32Health](https://www.point32health.org/). **Job Summary** Reporting to the Vice President of Network and Provider Performance Management, the Director of Network and Provider Analytics plays a strategic leadership role with the Provider Partnerships organization. The Director manages a team of managers and analysts, working in a matrix environment to support and collaborate with colleagues from System Contracting, Ancillary Contracting, Actuarial, Sales and Provider Performance. He/she oversees the development and timely delivery of relevant and meaningful financial analyses in support of Point32Health’s provider contracts and network performance for all commercial and government payor lines of business. **Job Description** DUTIES/RESPONSIBILITIES – what you will be doing (top five): * Proactively identify and oversee the development of analyses, models, and tools to offer an informed view of provider, network, and contract performance * In collaboration with System and Ancillary Contracting l

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