Sr Analyst, Network AnalyticsSHPCA SCAN Health Plan • Long Beach, California, United States

Jetzt Bewerben

Sr Analyst, Network Analytics

SHPCA SCAN Health Plan

Long Beach, California, United States

Long Beach, California, United States

Jetzt Bewerben

Über

Company Overview Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors". Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values‑driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next‑generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen— not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. Job Summary The Senior Analyst, Network Analytics supports SCAN’s strategic decision‑making across Network, Medical Economics, and related business partners by delivering analytics that improve network performance, affordability, access, and provider strategy. This role is responsible for analyzing provider performance, referral and leakage patterns, member utilization across in‑network and out‑of‑network settings, geographic access, reimbursement dynamics, and contracting opportunities to identify actions that improve total cost of care and network value. A core expectation of the role is the application of advanced analytics to SCAN's network optimization goals, including provider segmentation, geospatial analysis, opportunity identification, scenario modeling, and predictive or statistical methods that support network design and contracting decisions. The role combines strong analytical execution with business partnership, helping translate complex claims, provider, contract and market data into actionable insights for network strategy, provider negotiations, and performance improvement. Responsibilities Develop and maintain analyses related to network performance, provider utilization, total cost of care, leakage, steerage, out‑of‑network utilization, and site‑of‑care patterns to support affordability and network strategy decisions. Apply advanced analytics to network business objectives, including provider segmentation, opportunity modeling, stochastic modeling for risk‑sharing contracts, scenario modeling, and other quantitative methods that support network optimization and contracting strategy. Perform geospatial and access analyses, including provider‑to‑member access, travel distance and time, CMS adequacy requirements, disruption, and network expansion or narrowing scenarios. Support provider contracting strategy through analyses of reimbursement, utilization, referral patterns, competitive positioning, contract performance, and scenario modeling, including benchmarking utilization and cost patterns against fee‑for‑service Medicare to identify opportunities where changes in risk relationships, reimbursement approach, or network strategy may be warranted. Produce actionable reporting and insights on provider, market, and network performance for business partners in Network, Medical Economics, Finance, and other stakeholder groups. Analyze cost and utilization drivers across providers, specialties, facilities, service categories, and markets, and identify opportunities to improve value, efficiency, and member access. Partner with cross‑functional stakeholders to align on business priorities, structure analyses, interpret findings, and communicate clear recommendations and/or trade‑offs. Ensure analytic rigor, documentation, and data quality in recurring and adhoc analyses, including validation of methods, assumptions, and outputs. Contribute to the development of analytic tools, datasets, dashboards, and repeatable frameworks that improve the scalability, sophistication, and consistency of network analytics. Qualifications Graduate or advanced degree, or equivalent experience in analytics, economics, statistics, mathematics, public health, health administration, finance, data science, geography/GIS, actuarial science, or a related quantitative field. GIS or geospatial analytics experience, including tools such as ArcGIS, QGIS, or geospatial Python/R libraries. Familiarity with fee‑for‑service Medicare reimbursement and utilization benchmarking. Experience with Medicare Advantage, Medicaid, Commercial, or value‑based care analytics. 4+ years of experience in healthcare analytics, medical economics, network analytics, provider analytics, actuarial analytics, healthcare consulting, or a related field. Experience specific to healthcare claims, provider, eligibility, reimbursement, and/or contract data in a payer or managed care environment. Experience supporting provider contracting, network strategy, network adequacy, geospatial access analysis, reimbursement analysis, or provider performance analytics. Experience using advanced analytics to solve healthcare or network problems, including statistical modeling, predictive analytics, segmentation, scenario modeling, or optimization approaches. Actuarial experience or exposure is preferred but not required. Experience building agentic workflows (e.g., automated anomaly detection to identify network leakage). Experience working in modern data platforms such as Snowflake and/or Databricks. Strong SQL skills and ability to work with large, complex healthcare datasets. Ability to partner with data engineering teams to define underlying data models for provider and contract entities within the data warehouse. Ability to perform geospatial, access, adequacy, and disruption analyses; experience in ArcGIS or similar software. Ability to benchmark utilization and reimbursement patterns against fee‑for‑service Medicare. Ability to translate complex analyses into clear business insights and recommendations. Ability to manage multiple priorities and work effectively in a cross‑functional environment. Knowledge of healthcare claims, provider economics, reimbursement, and network performance concepts. Strong quantitative skills, including statistical, predictive, or scenario‑based analytic methods. Proficiency in Python, R, or similar analytical tools. Strong data visualization and presentation skills. Benefits Base salary range: $106,200 to $153,705 annually. Annual employee bonus program. Robust wellness program. Generous paid‑time‑off (PTO). 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days. Excellent 401(k) retirement saving plan with employer match. Robust employee recognition program. Tuition reimbursement. Opportunity to become part of a team that makes a difference to our members and community every day. Equal Opportunity / EEO Statement SCAN is proud to be an Equal Employment Opportunity and affirmative action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, marital status, disability, protected veteran status or any other status protected by law. A background check is required.
#J-18808-Ljbffr

Long Beach, California, United States

Sprachkenntnisse

English

Hinweis für Nutzer

Dieses Stellenangebot stammt von einer Partnerplattform von TieTalent. Klick auf „Jetzt Bewerben”, um deine Bewerbung direkt auf deren Website einzureichen.

Jetzt Bewerben