Job Description

LOCATION: Remote - This is a home based, virtual position that operates Monday - Friday from 8:30am-5:00pm (EST). Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.

GENERAL STATEMENT OF JOB

The Provider Network Analyst is responsible for providing technical support to Healthcare Analytics and the Provider Network Operations department by producing, analyzing, interpreting, and using reports needed for network analytics, monitoring of team and provider performance (volume and processing statistics), the generation of mass notifications for providers and data sharing across multiple platforms. Conducting network analysis through geo-access and other metrics to determine network needs across all levels of services.

ESSENTIAL JOB FUNCTIONS

Network Analysis:

• Responsible for the oversight and development of the annual Network Adequacy and Accessibility Analysis (Gaps Analysis)
• Responsible for Provider Network Operations oversight of network accessibility data as part of Tailored Plan requirements and the Network Access Plan
• Responsible for collecting, analyzing, and reporting provider network accessibility data as part of Tailored Plan requirements
• Support the ongoing monitoring of the Network Access Plan and implementing strategies to address gaps in the provider network
• Collect, analyze, and present detailed and statistical data and reports on provider network services for internal and external reporting
• Provide project management support for network development projects
• Direct the improvement of data analysis/presentation to support the use and understanding on statistical data
• Create and maintain dashboard reports to identify trends, outliers, and areas for improvement in the provider network
• Support the closed network provider enrollment process through the development of forms, policies, and business processes to maintain effective and timely business processes
• Support the migration of data through provider enrollment, credentialing, and contracting
• Interpret and evaluate data quality
• Develop programs, methodologies, and approaches for analyzing and presenting data to the Provider Network Operations department
• Maintain ongoing complex data analysis in support of ad hoc and scheduled reporting for internal and external stakeholders
• Generate routine network capacity reports
• Conduct surveys of providers and community stakeholders to determine the adequacy of services within the provider network
• Support quality improvement projects within Provider Network Operations and across the organization
• Provide support to internal and external Committees around provider specific data
• Ensure that the provider network meets the requirements set forth by the NC Medicaid vendor contract, delegation agreements, and national accreditation standards.

Report Analysis Back up:

• Will back up the Value Based Analytics Managers with all roles and responsibilities

Other duties as assigned.

KNOWLEDGE, SKILLS, & ABILITIES

• Knowledge of office and business practices in the completion of daily responsibilities.
• Maintain knowledge of changes in policy, methods, computer operations, equipment needs, etc., as they pertain to departmental operations and activities.
• Knowledge of Quest Analytics and/or geo-access coding is preferred
• Knowledge of SQL, and Excel (i.e. Pivot Tables, VLOOKUP and other functions) is preferred
• Able to communicate effectively and have daily interpersonal contact with the public, providers, supervisors, and other employees.
• Ability to assemble information in a concise, clear, and effective manner.
• Able to use independent judgment as situations warrant.
• Ability to comprehend, interpret and apply regulations, procedures, and related information.
• Adept at producing and interpreting management reports for internal and external audits and senior management.

EDUCATION & EXPERIENCE REQUIREMENTS

• An Associate Degree in Human Services, Business Administration, or related fields of study and 8+ years of experience in reporting and data analytics

OR

• A Bachelor's Degree in Human Services, Business Administration, or related fields of study and 5 years relevant experience in reporting and data analytics

PHYSICAL REQUIREMENTS

• Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
• Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
• Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
• Mental concentration is required in all aspects of work.

RESIDENCY REQUIREMENT: The person in this position must live in NC, SC, GA, TN, VA, MD, or FL.

SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

DEADLINE FOR APPLICATION: Open Until Filled.

APPLY: Vaya Health accepts online applications in our Career Center, please visit

Vaya Health is an equal opportunity employer.

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