Provider Network Analyst

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Dominion National at the time of posting and may be modified in the future. Dominion National offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more. 

Dominion National, a rapidly growing and leading provider of dental and vision benefits has an exciting opportunity for an experienced Provider Network Analyst.

The Provider Network Analyst role is responsible for guiding the efforts of the Provider Recruitment team by creating disruption reports, competitive analysis, and identifying areas of strength and weakness of our Provider network.  The candidate will analyze various datasets to assess network adequacy and identify opportunities for improvement.  The candidate will present insights and recommendations to stakeholders. This role serves as data expert and reporting analyst of Dominion’s provider networks. The Network Analyst’s duties involve programming various SQL Reporting queries and/or using Access or Excel to meet company analysis/reporting requirements. The Network Analyst will collaborate with team members in Account Management, Compliance and Operations.

Responsibilities and Qualifications

• Design algorithms and query logic to create data sets based on end user requirements.
• Build disruption lists by comparing datasets and identifying target opportunities for recruiting.
• Create geographical access reports using Quest to demonstrate coverage adequacy.
• Present insightful summaries with recommendations that include key themes, trends, and results to internal and external stakeholders.
• Coordinate, publish and maintain weekly/monthly report schedules.
• Analyze provider network and utilization by members; responsible for producing reports to ensure enterprise is compliant with ACA and other regulatory agencies, as well as client network adequacy and access requirements.
• Complete quarterly and annual GEO Access reporting requirements for internal and external clients, as well as ad hoc reporting.
• Develop network recruiting recommendations for leased network partners (Dentemax, PPOUSA, GRID) in order to maintain optimal network strength.
• Be source of truth for provider network questions (e.g., annual network size; ad hoc requests for network strength/size; comparison of Dominion network to competitors, etc.).
• Coordinator of all network reporting requirements.
• Design and run quality assurance reports to ensure the integrity of networks within DataDental.
• Ensure that all business deadlines are met according to published Action Plans.
• Develop visualizations and tracking dashboards that provide real-time insights into provider network performance and growth.
• Support provider network deliverables across markets by managing and analyzing provider data to support the organization's network operations and strategic objectives.
• Ensure data integrity, supports provider recruitment and payer requirements, and contributes to cross-functional projects that enhance network processes and performance.

The minimum qualifications for the ideal candidate include: 

• 2–5 years of experience as a data analyst. preferably in dental or healthcare.
• Proficient in data management and analysis tools (Excel, Access, SQL, Power BI), data visualization, and Microsoft Office).
• Experience with Salesforce, Quest Analytics and Net360 (or similar) preferred.
• Strong analytical skills and attention to detail; ability to develop and interpret complex data and communicate insights.
• Experience creating compelling presentations of key findings from an analysis, (e.g., trends, gaps, growth projections, etc.) that inform network performance and strategic decisions.
• Experience building visualizations and tracking dashboards to provide real-time insights into provider network performance and growth. 
• Excellent verbal, written communication, and presentation skills.
• High School Diploma or equivalent required.
• Bachelor's degree, data management certifications or equivalent experience preferred.

Physical Demands:

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.