Provider Network Adequacy Analyst
Creates monthly network adequacy reports by line of business, analyzes results and communicates findings to provider contracting team to assure regulatory compliance with network adequacy standards.
Prepares network disruption reports and runs "what if?" analysis to model the impact of provider network changes on network adequacy.
Collaborates with provider contracting and sales teams to understand and respond to provider network reporting requirements.
Manages provider network access agreements and prepares provider network data for Requests for Proposals (RFPs).
Creates and maintains documentation and workflows for provider data extracts and provider network adequacy reporting.
- College degree or minimum of 1 to 5 years experience in managed care organization;
- Experience using GeoAccess and/or Quest Analytics software programs;
- Competency with provider data structure and how provider data structure impacts network adequacy reporting;
- Strong communication skills (oral and written);
- Proficiency with Microsoft Word, Excel, Power Point and Outlook.
- 2 to 4 years experience with Quest Analytics software;
- Ability to handle multiple tasks and/or projects at one time;
- Experience completing provider network responses to RFPs.