Director, Business Analytics

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🕒 vor 5 Tagen

🐊 Florida – Remote

🐊 Florida – Remote

💵 $170.000 - $185.000 / Jahr

⏰ Vollzeit

🔴 Experte

👔 Direktor

Jetzt Bewerben

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Health Network One

WebsiteLinkedInAlle Stellen

201 - 500 Mitarbeiter

Gegründet 1999

⚕️ Krankenversicherung

🤝 B2B

Healthcare Insurance • B2B

Health Network One ist ein Unternehmen für Gesundheitsnetzwerkmanagement, das mit Krankenversicherungen zusammenarbeitet, um spezialisierte ambulante Dienste (einschließlich ambulanter Therapie, routinemäßiger und medizinischer Augenpflege, Dermatologie und Fußpflege) unter Vollrisiko-Vereinbarungen zu verwalten. Das Unternehmen ist landesweit tätig, deckt über 7 Millionen Leben ab und arbeitet mit Zehntausenden von Anbietern zusammen. Es bietet delegierte Dienstleistungen wie Nutzungsmanagement, Akkreditierung, Schadens- und Netzwerkmanagement an. Health Network One legt Wert auf wertorientierte Lösungen, klinische Qualität, Kostensenkung für fachliche Ausgaben und Einrichtungsaufwand, und besitzt eine NCQA-Akkreditierung sowie eine HITRUST CSF Zertifizierung.

Beschreibung

• 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

🎯 Anforderungen

• 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.