Demo

Provider Network Data Analyst - Healthcare (Contracting / Network Pricing)

AmeriHealth Caritas
Newtown, PA Full Time
POSTED ON 3/7/2025
AVAILABLE BEFORE 6/6/2025

Responsibilities

  • Collaborates with Actuarial, Network, and Operational areas to develop lenses that provide event triggered output for monitoring of impending contract changes and provider patterns.
  • Effectively prioritizes and communicates insights and recommendations.
  • Facilitates partnerships with Vendors, IT, Payment Systems, Operations Services, Provider Network Management, Market, and Clinical teams as needed to research financial issues, risks, and opportunities related to fee schedules, chargemasters, contract terms, and outliers.
  • Manages issue-tracking database to ensure that challenges are resolved within established timeframes and escalates open issues as needed.
  • Defines, develops, and / or implements data modeling tools or reports designed to routinely assess and support existing and new provider network management processes, programs, contract performance, and proposed initiatives, such as fee schedule development, provider contract interpretation’ and system interfaces / integration.

Education / Experience :

  • Bachelor’s Degree required.
  • At least four (4) years of Analytics experience.
  • Advanced Microsoft Excel experience required.
  • Experience with SQL and BI Tools such as Power BI or Tableau required.
  • Superior analytical skills including the use of very large data sets; ability to recognize anomalies in findings, and pursue and / or recommend resolution.
  • Ability to work with integrated data from multiple sources.
  • Other relevant experience includes work with Databricks, SAS, Python, and R.
  • Demonstrated ability in effectively interfacing with key leaders and stakeholders both internal and external to the organization to research technical and / or operational issues and define solutions.
  • Must have excellent communication skills.
  • Diversity, Equity, and Inclusion

    At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

    We keep our associates happy so they can focus on keeping our members healthy.

    Our Comprehensive Benefits Package

    Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

    Generous paid time off and paid volunteer time off.

    Employer-matched 401(k) and additional non-elective contributions, starting on day one.

    Medical, dental, and vision plans — with coverage starting on day one.

    Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

    Employer-paid life insurance, with opportunities to purchase additional coverage.

    Employer-paid short-term disability coverage and long-term disability coverage.

    Tuition assistance, including reduced tuition at certain schools.

    Financial assistance with adoption, including paid time off.

    Flexible spending and health savings accounts to pay for qualified expenses.

    Discount programs on entertainment, travel, and more.

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