PBACO Holding LLC

Job DescriptionJob Description Summary The Specialist Network Analyst is responsible for analyzing, monitoring, and optimizing the structure and performance of the ACO's provider network. This role supports strategic decision-making by evaluating provider adequacy, referral patterns, quality and utilization metrics, and geographic coverage. The Specialist Network Analyst combines advanced data analysis skills with a working knowledge of healthcare delivery systems and value-based care to guide network growth and performance improvement initiatives. Key Responsibilities Network Analytics & Reporting Analyze provider network composition, coverage, and performance using claims, utilization, and quality data. Identify gaps in network adequacy and access across service lines and geographies. Develop reports and data visualizations to support leadership in network development, expansion, and optimization. Monitor referral patterns, provider attribution, and leakage trends to inform retention and contracting strategies. Performance Monitoring Track and report on provider and network-level performance against cost, quality, utilization, and risk adjustment benchmarks. Collaborate with provider engagement, contracting, and quality teams to ensure the network meets value-based performance targets. Assist in identifying high-performing providers and practices for incentive programs and strategic partnerships. Data Management & System Support Maintain accurate and up-to-date provider rosters and network configurations within internal systems. Support data integrity efforts for provider directories, credentialing information, and contract records. Partner with IT, analytics, and population health teams to streamline data collection, validation, and reporting processes. Contracting & Strategic Insights Provide contracting and leadership teams with performance data and impact analyses to guide negotiations and network planning. Model the financial and operational impact of new provider partnerships and network composition changes on ACO performance and shared savings. Conduct market research and competitive analysis to identify potential providers aligned with ACO growth strategies. Supervisory Responsibilities This job has no supervisory responsibilities. Qualifications Education & Experience Bachelor's degree in Data Analytics, Biostatistics, Public Health, Healthcare Administration, Business, or related field required. Minimum of 3 years of experience in healthcare analytics, network development, provider relations, or managed care. Familiarity with healthcare claims data, provider file structures, and value-based payment models (e.g., MSSP, ACO REACH, Medicare Advantage). Skills & Competencies Strong analytical and problem-solving skills; advanced proficiency in Excel and SQL. Proficiency with data visualization tools (e.g., Tableau, Power BI) to create actionable insights. Ability to interpret healthcare data, performance metrics, and network configurations. Knowledge of healthcare delivery systems, provider specialties, and clinical service lines. Excellent organizational skills, with the ability to manage multiple data sources and competing priorities. Strong written and verbal communication skills; able to present complex data clearly to non-technical audiences. Experience with Medicare, Medicaid, or commercial ACO networks. Exposure to geographic mapping tools (e.g., ArcGIS, Mapbox) for network adequacy analysis. Familiarity with CMS attribution methodologies and risk adjustment models (e.g., HCC). Knowledge of Electronic Health Records (EHRs), population health platforms, or provider directory systems. Language Skills Ability to analyze, interpret, and summarize technical and healthcare-related data. Strong communication skills with the ability to produce clear reports, presentations, and recommendations. Reasoning Ability Applies structured problem-solving to analyze network gaps, identify risks, and develop actionable solutions to improve network efficiency and provider engagement. Computer Skills Advanced skills in Excel and SQL required. Proficiency in data visualization platforms (Tableau, Power BI) and familiarity with provider data systems and relational databases preferred. Other Skills and Abilities Maintains the highest standards of accuracy and confidentiality. Strong attention to detail, critical thinking, and initiative. Ability to work independently while collaborating effectively across teams. Physical Demands While performing the duties of this Job, the employee will have a combination of standing, sitting, bending and reaching. May work at a computer monitors for prolonged periods. The employee may lift and/or move up to 10 pounds.