Director, Provider Network Management & Analytics (Medicare) - REMOTE

Job Summary

Responsible for accurate and timely measurement of critical provider analytics including Network Adequacy and other critical metrics. Synchronizes data among multiple systems to ensure accurate reporting of the Provider Network across the enterprise. Validates data on provider databases and ensures adherence to business, system and regulatory requirements of Provider Data Management / Network Adequacy.

Contributes as a key member of the Leadership Team and other committees addressing the strategic goals of the department and organization. Develops and implements Provider Network and Contract strategies across all lines of business, identifying those specialties and geographic locations on which to concentrate resources for purposes of establishing a compliant network of participating Providers to serve the health care needs of the Plan's membership and to meet all state and federal requirements. Actively mentors team members focused on analytics, reporting, and technical skill development based on personal experiences and skills in these areas of focus. Creates an environment where data and analytics professionals can develop their skills and grow their careers through taking on increased responsibility and adding value to the organization. Ensures strong operational processes are in place to deliver across all areas of responsibility. Provides oversight analyses of demographic data to support accurate Network Adequacy Reporting and Directory development. Manages multiple resources and projects concurrently to ensure successful completion of analytic projects, including timeliness, quality and customer value. Provides accurate analytic work estimates and oversees delivery against resources, ensuring organization design and team are in place to deliver against plans. Serves as primary client contact on all phases of analytic projects from problem definition, assignment of resources and through to resolution, appropriately managing internal customer expectations throughout the project. Creates compelling presentations for internal customers, senior leaders and sales teams, which tell the analytic story, demonstrating their value by providing actionable insights with recommendations. Capitalizes on opportunities to cross-sell analytic tools and solutions to existing internal customers, market the value of analytics services across the enterprise. Integrates work with other teams including New Markets team, Network Management, Product Teams, PDM and IT.

Job Qualifications

Required Education : Bachelor's Degree in a related field (Business Administration, Finance, Mathematics, Statistics, Computer Science etc.) or equivalent experience. Required Experience : 7 - 10 years' experience in delivering analytic results working within complex data sets and analytics ideally in the Healthcare or Payer field. 3-5 years' experience managing / supervising employees or leadership capacity. Strong executive-level client facing skills and the ability to communicate complex analytical concepts with confidence to a non-technical executive audience. Ability and willingness to take a hands-on execution role where required to support client needs and team development. Highly organized with an ability to work under tight deadlines and shifting priorities. Excellent oral and written communication skills. Management and team mentoring. Highly professional and presentable with a strong business acumen.

Preferred Education : Master's Degree. Preferred Experience : Advanced Excel skills. Power BI. Provider Data Analytics.