TriWest Healthcare Alliance

Provider Ntwrk Adequacy Anlyst

Recruiting Location Phoenix, AZ
ID 2021-3348

Overview

Job Summary

Provides and develops processes for reports, analysis and metrics to support recommendations regarding provider network accessibility and capacity against demand for services across a vast geography and wide array of services. Plays a key role in the development and maintenance of the demand capacity tool that is used to help analyze network accessibility/capacity and for managing requests for additional providers to address gaps. Provides analytical support and supports internal customers with network assessments and corrective actions to address deficiencies. Produces outcome and program reports and suggests strategies and recommendations for improvement. Initiates and maintains department corrective action plans.

Responsibilities

 

Key Responsibilities

•           Performs analysis to assess accessibility and capacity of provider network
•           Supports others in assessments
•           Develops, manages and tracks corrective action plans to address provider network gaps
•           Maintains and improves demand capacity and network adequacy tools
•           Identifies, designs, and conducts network adequacy/capacity assessments.
•           Monitors program metrics and resulting outcome reports. Writes and produces professional quality internal and external position papers, reports and plans.
•           Compiles and analyzes network adequacy data to prepare reports for submission.  
•           Performs other duties as assigned.
•           Regular and reliable attendance is required

Qualifications

Education & Experience

Required

  • Bachelor's degree in Business, Health Care Administration, Data Analysis, or related field
    • 3+ years working for health plan/payor environment dealing with network development and network analysis
    •         Experience with project management, research, program development and evaluation, reporting, business and operational planning, and process improvement
    •         Experience identifying, implementing and monitoring network adequacy based projects

Preferred

  • Data analytics experience
    • Project management certification
    •         3 years experience with data management, statistical analysis, report design and presentation

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