Director, Business Analytics

Vaga não está no LinkedIn

🕒 Junho 4

🐊 Florida – Remoto

🐊 Florida – Remote

💵 $170.000 - $185.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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Health Network One

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 1999

⚕️ Seguro de Saúde

🤝 B2B

Healthcare Insurance • B2B

A Health Network One é uma empresa de gestão de redes de assistência médica que faz parcerias com planos de saúde para gerenciar serviços ambulatoriais especializados (incluindo terapia ambulatorial, cuidados oftalmológicos de rotina e médicos, dermatologia e podologia) sob acordos de risco total. A empresa opera nacionalmente, cobrindo mais de 7 milhões de vidas e contratando com dezenas de milhares de prestadores, oferecendo serviços delegados como gestão de utilização, credenciamento, gerenciamento de reivindicações e de rede. A Health Network One enfatiza soluções baseadas em valor, qualidade clínica, redução de custos para gastos profissionais e de instalações, e possui acreditação da NCQA e certificação HITRUST CSF.

Descrição

• Lead analytics initiatives supporting total cost of care performance across specialty services • Identify drivers of specialty spend across specialties such as vision, dermatology, therapy etc., • Monitor PMPM trend performance across specialties and all lines of business. • Evaluate utilization patterns and recommend cost-reduction opportunities • Design analytics frameworks measuring provider efficiency, access, and quality performance • Evaluate book-of-business claims experience to develop insights on profitability and competitive positioning across products and markets • Support underwriting and growth teams with data analysis and insights for new client proposals and value propositions • Analyze site-of-care optimization opportunities, network leakage and utilization across provider networks • Support contract performance evaluation and savings analysis • Partner with finance, clinical and operational leadership to define and develop KPIs aligned with enterprise performance goals. • Present insights and recommendations to leadership in a clear, concise, and data-driven manner • Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility. • Mentor junior analysts and strengthen analytics capabilities across teams. • Drive automation of manual reporting workflows and implementation of scalable reporting solutions. • Establish documentation standards, reporting governance processes, and analytics best practices. • Support integration of AI tools into technical operations • Perform other duties as needed

🎯 Requisitos

• Bachelor’s degree (or equivalent experience) in public health, data analytics, health informatics, business, or a related field. • 8+ years of experience with advanced proficiency in SQL, Excel, and Power BI/Tableau in healthcare analytics environments • 5+ years of experience working with healthcare datasets, including claims, utilization management/prior authorization, care management, and quality measures. • Demonstrated leadership managing analytics teams • Strong understanding of clinical workflows, utilization and network management analytics, and healthcare economics. • Demonstrated ability to translate complex analytics into executive-level insights and operational recommendations. • Experience developing presentation materials that articulate insights clearly and persuasively • Displays willingness and ability to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions • Strong analytical mindset with intellectual curiosity and a passion for problem-solving. • Superior attention to detail and strong organizational skills, with the ability to operate effectively in a fast paced, high demand environment while managing multiple priorities • Exceptional verbal and written communication skills, with a bias toward clarity, brevity, and decisive communication.