Are you interested in becoming part of a dynamic team that is looking to innovate and improve? Would you like to work for a company that has been rated by the BBJ (15+yrs) as one of the best places to work? Do you want to be part of a company that is committed to giving back to the community?

Harvard Pilgrim Health Care is currently seeking highly motivated individuals to join our organization as a Sr Network Design & Administration Analyst. The Sr Network Design & Administration Analyst is responsible for analyzing network data from conceptualization through presentation. They will identify and advise Provider Network Management of trends, problems, opportunities, and issues. They will be responsible for providing network design, regulatory compliance, and reporting of network administration performance. They are expected to coordinate sharing of provider data and communicate consistently with Provider Management staff and other departments as necessary, to ensure efficient, timely and accurate flow of information.

Job Description

WHAT YOU WILL BE DOING:

• Provide internal and external constituents with strategic decision making on network design through the delivery of dashboard reporting with actionable metrics.
• Collect, review and interpret data to create a comprehensive assessment of network integrity that identify opportunities and inform strategic decisions.
• Develop most effective method to communicate information (i.e., presentation, reporting dashboard, etc.).
• Understand and independently complete data requests including but not limited to provider network data, network-based product data, and cost and utilization data.
• Create and suggest analytics that will assist in reviewing and determining overall network performance and integrity as well as provide recommendations based on results.
• Provide subject matter expertise to and collaborate with internal departments such as; Product, Sales, Legal, Compliance, IT, Contracting, NCQA Quality teams etc. to understand, meet, or intervene on deliverables.
• As well as support workgroups/committees associated with key corporate business goals and initiatives.
• Perform out-of-the-box thinking, collaborate with others, and make a difference every day!
• Other duties and projects as assigned.

Requirements

WHAT YOU NEED:

• 7+ years of related experience
• BA in business, information systems, ore related field preferred.
• Advanced Excel skills, Geo Analytical Software, experience with MS Access, SQL Server, BI suites such as Tableau, or other enterprise class tools
• Excellent verbal, written, interpersonal, organizational and communication skills.
• Ability to coordinate several projects simultaneously and with tight deadlines and re-prioritize workload or escalates issues as needed with minimal intervention.
• Ability to understand varying health plan network design, products, and regulatory requirements.

WHAT MAKES US STAND OUT:

• Work-Life-Flexibility Paid volunteer time off (up to 3 days annually)
• Open Time Off (include for exempt positions only)
• Annual Mini-Grant of $500 donated to a non-profit organization of the employee's choice
• Educational Reimbursement
• Working Environment Standard Office Environment. May be required to travel to provider offices, hospitals and professional trade associations and other HPHC locations as required.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

Please note: As of January 18, 2022, all employees — including remote employees — must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

About Us

Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

At Point32Health, we’re working to reshape the world of health care by pushing past the status quo and delivering even more to the diverse communities we serve: more innovation, more access, more support, and healthier lives. And we want people like you on our side to make it even better.

This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R3818

#TalentBoostPoint32Health

Posted On: Tuesday, June 21, 2022