Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
The Network Management & Contracting Business Analyst provides analytical, reporting, and operational support across Network Management, Provider Engagement, and Contracting functions.
This role serves as a centralized resource for network performance, regulatory and accreditation reporting, provider data, network adequacy, audit readiness, and key initiatives.
Roles and Responsibilities
Regulatory & Accreditation Reporting
- Support the preparation, analysis, tracking, and timely submission of required state, regulatory, and accreditation-related network reports.
- Monitor reporting requirements, findings, approvals, corrective actions, and related committee activities.
- Maintain documentation and supporting evidence to promote ongoing regulatory and audit readiness.
- Coordinate and monitor network-related projects and enterprise initiatives that impact providers, contracting, provider data, and network operations.
Network Adequacy & Performance Analysis
- Analyze network adequacy and accessibility across primary care, specialty, behavioral health, and other provider types.
- Evaluate geographic access, availability, utilization, compliance regulations, out-of-network activity, and other network performance indicators.
- Identify potential network gaps, trends, risks, and opportunities for improvement.
- Support the development and monitoring of action plans resulting from network analyses.
Process Improvement
- Identify recurring issues, workflow gaps, and opportunities to improve network and contracting operations.
- Recommend solutions that enhance efficiency, accountability, data accuracy, reporting, and provider experience.
- Support implementation and measurement of process-improvement initiatives.
Required Qualifications
- 5 years of experience as a Business Analyst, Data Analyst, or Data-focused Product Owner, with exposure to data governance and quality initiatives.
- Demonstrated ability to quickly learn and navigate complex systems, applications, and data structures to effectively troubleshoot technical issues, identify root causes, and drive timely resolution.
- Demonstrated ability to prioritize competing priorities for work based on business and client needs, along with being able to describe the prioritization decision making to influence prioritization.
- Candidates must reside in the state of Kentucky.
- Travel may be required based on business needs, including attendance at meetings, training sessions, client engagements, and other company-related events.
- Strong proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint.
Preferred Qualifications
- 3 to 5 years of experience in healthcare, including hands-on experience with core concepts and data (e.g., claims data formats, risk adjustment methodologies, and provider network management).
- Prior project management experience, including the ability to lead cross-functional initiatives, manage timelines and deliverables, coordinate stakeholders, and drive projects to successful completion.
- Demonstrated ability to solve complex technical problems through tracing data from generation and ingestion to systems and reporting.
- SQL proficiency with proven experience writing queries for investigation, root cause analysis, and defining precise reporting logic.
Education
- Bachelor's degree, or equivalent combination of education and professional experience.
Anticipated Weekly Hours 40
Time Type Full time
Pay Range $54,300.00 - $119,340.00
Benefits This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.