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Provider Network Management Analyst

Community Behavioral Health

This is a Full-time position in Philadelphia, PA posted October 26, 2021.

Community Behavioral Health (CBH) is seeking a Data Analyst that will be primarily responsible for supporting the Provider Network Management team with data analysis to inform provider network adequacy, capacity and disparities to address need areas to support timely and effective access to behavioral health services and meet network adequacy standards.

CBH offers it’s employees: 

  • Competitive compensation 
  • 90%+ employer paid health insurance premiums with $0 deductibles 
  • 403b plan with high match contribution 
  • Generous vacation, sick, personal and holiday paid time off 
  • Tuition and certification reimbursement 
  • Wellness programs 
  • Work from home opportunity and flexible schedule

    Essential Functions

    • Maintain thorough and complete knowledge of the CBH provider network, including as new initiatives are implemented.
    • Conduct and create ongoing process for data analysis, reviewing the accuracy and integrity of data; monitoring the provider network against member demographics, utilization and other targeted population indicators.
    • Lead provider network analyses and create reports to evaluate service utilization, adequacy and accessibility
    • Conduct ongoing research in relation to provider network management and offer recommendations to ensure alignment with the PA Department of Human Services’ Healthchoices Behavioral Health Program Standards and Requirements.
    • Assist with updating annual Provider Network and Member Needs Assessments.
    • Run reports as requested by regulatory bodies
    • Liaise with Information Technology (IT) department and other relevant departments to complete data-oriented tasks.
    • Gather and interpret data as well as offer recommendations for program/service proposals and need areas identified through Network Adequacy
    • Review and prepare analysis for procurements, including relevant demographics, treatment utilization and related gaps for target populations  
    • Create protocol (in conjunction with the unit Manager) regarding how data will be obtained, evaluated and incorporated into Provider Network Management projects
    • Work with Provider Network Management team members to ensure efficient workflow of procurement process
    • Perform other related duties and projects as assigned. 
    • Ability to travel and work nontraditional work hours when necessary 

    Position Requirements: 

    • Education: Bachelor’s Degree in Healthcare Management, Public Health, or Analytical Field required. Master’s Degree preferred. 
    • License/Certification: N/A
    • Relevant Work Experience: 3  years of direct experience working in a managed care environment with information systems, data analytics, and/or provider operations  
    • Skills:
    • Knowledge of the Pennsylvania Medicaid program
    • Strong data analytics experience
    • Advanced critical thinking and analytical skills to interpret sometimes ambiguous requirements 
    • Encourage and promote active team process engagement and individual ownership
    • Exceptional communication (verbal and written) skills
    • Strong attention to detail to ensure quality and accuracy in deliverables
    • Comfortable with ambiguity and able to set your own direction
    • Must work well under pressure and be able to meet aggressive deadline
    • Ability to manage and coordinate multiple projects and deadlines while meeting quality standards 
    • Intermediate proficiency in Microsoft Outlook, Word, Excel and PowerPoint
    • Experience with Network Analysis software and reporting such as GeoAccess
    • Experienced user of Microsoft Access and SQL programming
    • Must have the ability to quickly learn and use new software tools

    Equal Employment Opportunity: Community Behavioral Health (CBH) provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, gender identity, sexual orientation, individual genetic information or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.

    Americans with Disabilities Act: Applicants as well as employers who are or become disabled must be able to perform the essential job functions either unaided or with reasonable accommodation.  The organization shall determine reasonable accommodation on a case-by-case in accordance with applicable law. 

    This job profile reflects management’s assignment of current duties, responsibilities, and essential functions; it does not prescribe all or restrict the tasks that may be assigned now, or in the future, relevant to the responsibilities for this position.  Community Behavioral Health (CBH) may change the specific job duties with or without prior notice based on the needs of the organization.