Director, Business Analytics

Job not on LinkedIn

🔥 4 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $170k - $185k / year

⏰ Full Time

🔴 Lead

👔 Director

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Health Network One

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1999

⚕️ Healthcare Insurance

🤝 B2B

Healthcare Insurance • B2B

Health Network One is a healthcare network management company that partners with health plans to manage specialty outpatient services (including outpatient therapy, routine and medical eye care, dermatology, and podiatry) under full-risk arrangements. The company operates nationally, covering over 7 million lives and contracting with tens of thousands of providers, and offers delegated services such as utilization management, credentialing, claims and network management. Health Network One emphasizes value‑based solutions, clinical quality, cost reduction for professional and facility spend, and holds NCQA accreditation and HITRUST CSF certification.

📋 Description

• 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

🎯 Requirements

• 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.