SCOPE OF ROLE

The Network team is responsible for building, optimizing, and transforming Care Partner’s networks into market leading integrated delivery systems. The Senior Provider Data Analyst collaborates with other teams at Bright, including Care Partner and business development, market leadership, health optimization, distribution, marketing, operations, analytics, legal, and finance. Represents Bright to external partners, including identifying and developing key new participants of Bright’s insurance networks.

ROLE RESPONSIBILITIES

The Senior Provider Data Analyst, Network Strategy description is intended to point out major responsibilities within the role, but it is not limited to these items.

• Support advancement of network design strategy, overseeing development of proprietary Bright standards, alignment to regulatory requirements, and evaluation of development needs across both active and new markets.
• Build proprietary Bright standards for quality and access that encompasses individual, practice, and overall downstream ecosystem performance for professional, facility, and ancillary providers.
• Own development plan construction and oversight for active and new markets, including but not limited to initial diligence, prioritization, re-prioritization based on network development progress. Produce reporting to highlight network development progress and create scenario analyses to understand the impact of contracting with prospective provider groups.
• Identify, develop and implement best practices for network growth and optimization.
• Facilitate internal and external stakeholder discussions using provider data analytics to drive decision making and constant progress towards the goal.
• Analyze existing and potential Care Partner networks against regulatory standards to inform market viability.
• Contribute to the development of best practices for reimbursement level/structure as well as provider contract negotiation/execution in new and existing Bright markets.
• Support State and Federal Regulatory Network Filings in live and expansion markets, providing provider reporting materials as needed.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Bachelor’s degree required. Mathematics, Economics, Healthcare or other quantitative discipline preferred.
• Three (3)+ years of experience, ideally at a consulting firm, investment back, healthcare provider, payer, or vendor required.
• A passion for and experience in the healthcare services or other highly regulated sectors

PROFESSIONAL COMPETENCIES

• Strong, creative thinking skills with the ability to analyze problems which may require multiple and/or unconventional approaches
• Desire and ability to quickly move between highly detailed analytics and big picture strategic thinking
• Excellent multitasking and prioritization skills with a proven ability to manage multiple projects in parallel to completion
• Bias toward action; sense of urgency, self-initiative, and ownership of work
• Superb written and verbal communication skills
• Ability to organize and collaborate on internal and external-facing projects across cross-functional teams
• Strong knowledge of and experience working with healthcare data including but not limited to claims, testing results and pharmacy data required
• Experience with MS Excel functions that include working with large data sets, creating standardized reports, utilizing vLookups and advanced functions/ formulas, creating, using and interpreting pivot tables, filtering and formatting.
• Strong data querying skills using tools such as MS Access, SQL, and SAS Enterprise Guide required
• Ability to prepare dashboards and presenting data using a data visualization tool such as Tableau and Power BI
• Excellent prioritization skills with a proven ability to manage multiple people and projects in parallel.
• Strong organizational design capabilities with the ability to creatively and strategically structure complex problems.
• Responsible for training new employees and developing existing employees.
• Is an effective communicator. Internally, leads 1:1 and small groups of people in meetings. Capable of developing agenda, setting objectives, driving clarity of purpose and delivering the intended results. Can clearly articulate an inspiring goal/objective for each teammate and define success.

WORK ENVIRONMENT

• The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
• Some travel may be required.