Job Description
COMPANY OVERVIEW
At Harbor Health, we’re transforming healthcare in Texas through collaboration and innovation. We’re seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model.
If you’re ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!
POSITION OVERVIEW
Harbor Health is seeking a data-driven Network Analyst to join our innovative payvider organization in Texas. This role is critical in optimizing our provider network performance, ensuring member access to quality care, and driving strategic decisions through comprehensive network analytics. The ideal candidate will bridge the gap between healthcare delivery and insurance operations, using advanced analytics to shape how our members experience care while maintaining cost-effectiveness and quality standards.
POSITION DUTIES & RESPONSIBILITIES
Network Performance & Analytics
- Analyze provider network adequacy, accessibility, and geographic coverage to ensure members have appropriate access to care across all service areas
- Develop and maintain dashboards tracking key network metrics including utilization patterns, member attribution, provider capacity, and appointment availability
- Conduct time and distance analyses to validate network compliance with regulatory standards and member access requirements
- Generate regular reports on network performance indicators, identifying trends and opportunities for optimization
Provider Data Management
- Maintain accuracy and integrity of provider data across multiple systems, ensuring seamless integration between clinical and claims platforms
- Analyze provider performance metrics including quality scores, member satisfaction, cost efficiency, and clinical outcomes
- Support provider contracting decisions with data-driven insights on reimbursement rates, utilization patterns, and market benchmarks
- Create predictive models to forecast network needs based on member demographics and health risk profiles
Strategic Network Development
- Identify gaps in specialty coverage and recommend targeted recruitment strategies to enhance network comprehensiveness
- Analyze referral patterns and care pathways to optimize network configuration and reduce out-of-network utilization
- Evaluate potential network partners using comprehensive scoring methodologies incorporating quality, cost, and member experience metrics
- Support value-based care initiatives by analyzing provider performance against quality and efficiency targets
Cross-Functional Collaboration
- Partner with Clinical Operations to ensure network design supports care coordination and member health outcomes
- Work closely with Product & Engineering teams to best leverage automation & tools that are custom-built for Harbor
- Collaborate with Member Experience teams to address access concerns and optimize provider-member matching
- Work with Finance to model network costs and project impact of network changes on medical expense
- Support Compliance in maintaining network adequacy filings and regulatory reporting requirements
DESIRED PROFESSIONAL SKILLS & EXPERIENCE
Required Qualifications
- Bachelor's degree in Healthcare Administration, Data Analytics, Statistics, Health Informatics, or related field
- 3+ years of experience in healthcare analytics, preferably within managed care or provider network management
- Advanced proficiency in SQL and data visualization tools (Tableau, Power BI, or similar)
- Strong understanding of healthcare reimbursement models, including fee-for-service and value-based arrangements
- Knowledge of CMS and state regulatory requirements for network adequacy and access standards
Preferred Qualifications
- Experience working in payvider or integrated delivery system environments
- Proficiency in Python, SQL or R for advanced statistical analysis
- Understanding of risk adjustment methodologies and quality measure specifications (HEDIS, Stars)
- Experience with claims data analysis and healthcare-specific data sources
- Familiarity with provider credentialing and directory management processes
- Knowledge of Texas healthcare market dynamics and provider landscape
- Familiarity with GeoAccess, Quest Analytics, or similar network adequacy tools
Core Competencies
- Exceptional analytical and problem-solving skills with attention to detail
- Ability to translate complex data into actionable insights for diverse stakeholders
- Strong project management skills with ability to manage multiple priorities
- Excellent written and verbal communication skills
- Self-motivated with ability to work independently in a fast-paced startup environment
- Collaborative mindset with enthusiasm for cross-functional teamwork
WHAT WE OFFER
- Opportunity to shape the financial foundation of an innovative healthcare model
- Collaborative and dynamic work environment
- An organization made of people who are passionate about changing the healthcare landscape
- Competitive salary and benefits package
- Professional development and growth opportunities
- A transparent and unique culture
At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!
Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive environment for all clinicians and teammates and actively encourage applications from people of all backgrounds.
Job Tags
Full time,