Health Network One is a company focused on analytics initiatives in the healthcare sector. The Director of Business Analytics will lead efforts to analyze specialty services, monitor performance trends, and provide insights for cost reduction and efficiency improvements.
Responsibilities:
- Lead analytics initiatives supporting total cost of care performance across specialty services
- Identify drivers of specialty spend across specialties such as vision, dermatology, therapy etc
- Monitor PMPM trend performance across specialties and all lines of business
- Evaluate utilization patterns and recommend cost-reduction opportunities
- Design analytics frameworks measuring provider efficiency, access, and quality performance
- Evaluate book-of-business claims experience to develop insights on profitability and competitive positioning across products and markets
- Support underwriting and growth teams with data analysis and insights for new client proposals and value propositions
- Analyze site-of-care optimization opportunities, network leakage and utilization across provider networks
- Support contract performance evaluation and savings analysis
- Partner with finance, clinical and operational leadership to define and develop KPIs aligned with enterprise performance goals
- Present insights and recommendations to leadership in a clear, concise, and data-driven manner
- Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility
- Mentor junior analysts and strengthen analytics capabilities across teams
- Drive automation of manual reporting workflows and implementation of scalable reporting solutions
- Establish documentation standards, reporting governance processes, and analytics best practices
- Support integration of AI tools into technical operations
- Perform other duties as needed
Requirements:
- Bachelor's degree (or equivalent experience) in public health, data analytics, health informatics, business, or a related field
- 8+ years of experience with advanced proficiency in SQL, Excel, and Power BI/Tableau in healthcare analytics environments
- 5+ years of experience working with healthcare datasets, including claims, utilization management/prior authorization, care management, and quality measures
- Demonstrated leadership managing analytics teams
- Strong understanding of clinical workflows, utilization and network management analytics, and healthcare economics
- Demonstrated ability to translate complex analytics into executive-level insights and operational recommendations
- Experience developing presentation materials that articulate insights clearly and persuasively
- Displays willingness and ability to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions
- Strong analytical mindset with intellectual curiosity and a passion for problem-solving
- Superior attention to detail and strong organizational skills, with the ability to operate effectively in a fast paced, high demand environment while managing multiple priorities
- Exceptional verbal and written communication skills, with a bias toward clarity, brevity, and decisive communication
- Experience with data science tools and programming languages such as Python or R
- Experience incorporating AI into analytics workflows