Associate Provider Network Data Analyst (Remote in Tennessee)

American Health Partners - Franklin, TN

Full-time - Entry Level

Remote - Franklin, TN

Nursing and Residential Care Facilities

About the position

The Associate Provider Network Data Analyst plays a critical role in supporting cross-departmental communication and collaboration through data analysis and reporting. This role focuses on leveraging analytics to facilitate the efficient management of network expansion and audit activities, ensuring that network adequacy and regulatory compliance are maintained across multiple states.

Responsibilities

• Conduct weekly Network Analysis Reports using the J2 Health Network Adequacy Solutions Tool to assess and ensure network adequacy.
• Analyze and interpret large datasets, and create visual reports to effectively communicate findings.
• Perform detailed impact analysis on existing and potential networks when providers are added or removed, identifying potential gaps and areas for improvement.
• Ensure the consistent and timely updating of key tools and reports, such as the Red Light Green Light Master Dashboard and the States Comparison Summary, using J2 Health and Excel.
• Assist in developing and refining additional analytical tools and resources to support Network Development, Provider Relations, and other cross-functional teams.
• Monitor and manage the Provider Network Analyst Mailbox, ensuring all incoming requests are promptly addressed.
• Act as the primary point of contact for the contract rerouting process, specifically for Fee-For-Service (FFS) Letters of Agreement (LOAs).
• Assist the Provider Network Analyst and Director of Plan Network Operations to evaluate, create, and refine Standard Operating Procedures (SOPs).
• Work closely with the Provider Network Analyst and Director of Plan Network Operations to ensure alignment with network expansion and audit objectives.
• Collaborate with various departments to gather and analyze data, fulfill reporting requirements, and support strategic decision-making.

Requirements

• Bachelor's degree in a relevant field or 2 years of equivalent professional experience.
• Proficiency in data analytics and Microsoft Suite, particularly advanced Excel, Access, Word, Adobe Acrobat, and PowerPoint.
• Strong communication and collaboration skills.
• Ability to work independently and manage time effectively under tight deadlines.
• Strong focus on accuracy and detail.
• Ability to analyze complex data and solve challenges.

Nice-to-haves

• Experience in Provider Data Analytics, Provider Relations, Network Development, or Contract Review.
• Familiarity with Medicare Advantage, including CMS MA ISNP Program and CMS regulatory requirements.
• Knowledge of Provider Network Adequacy Review, conducting process audits, and developing SOPs, workflows, and job aids.
• Proficiency with Network Adequacy Solution Tools.

Benefits

• Affordable Medical/Dental/Vision insurance options
• Generous paid time-off program and paid holidays for full time staff
• TeleDoc 24/7/365 access to doctors
• Optional short- and long-term disability plans
• Employee Assistance Plan (EAP)
• 401K retirement accounts with company match
• Employee Referral Bonus Program