Network Development Analyst Healthcare Insurance

Job Description

Supports the Network Development team, 32BJ Health Insurance, in the management and expansion of the provider network. Responsible for gathering and analyzing data, generating reports, and assisting with the administrative aspects of the provider contracting lifecycle. Provides the analytical foundation required to support network strategy, negotiations, and performance monitoring.

Job Responsibility

1. Assists in the recruitment of hospital, ancillary, and professional providers by identifying network needs and preparing recruitment materials.

2. Gathers and analyzes provider data to support the financial modeling of contract proposals and assesses the financial impact of rate changes.

3. Prepares standard and ad-hoc reports on network adequacy, provider utilization, unit cost trends, and recruitment activities for internal stakeholders.

4. Maintains the integrity of the contract rate database and other departmental tracking tools, ensuring contract terms and rates are entered accurately and in a timely manner.

5. Supports Senior Advisors and Directors in preparing for contract negotiations by compiling data, performing market research, and drafting contract documents.

6. Acts as a point of contact for routine provider inquiries regarding contract status, rate sheets, and other operational matters.

7. Assists with the implementation of new and revised contracts, working with internal departments to ensure contract terms are loaded correctly.

8. Supports special projects and network initiatives by providing data analysis and project coordination assistance.

9. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

*Bachelor's Degree in Healthcare Administration, Business, Finance, Economics, or a related field required.

*1-3 years of relevant experience in a healthcare or analytics role; internships in a managed care or provider setting are a plus.

Preferred Skills:

• Act as a liaison between NWD and healthcare providers. Ensure effective communication and problem resolution to enhance patient care and operational efficiency and serve as the primary point of contact for these providers, addressing concerns and ensuring they understand policies and procedures.
• Manage the provider inbox. Monitor incoming provider communications, triage requests, and respond to inquiries within established turnaround times.
• Maintain accurate provider data, including credentialing and demographic updates. Assist in submitting provider data to external partners for claim adjudication and provider search functions.
• Assist with provider recruitment and engagement strategies in partnership with NWD leadership and other stakeholders.

*Additional Salary Detail

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).