Director, Provider Network & Analytics

Avalon Healthcare Solutions

$120K — $150K *
US-AnywhereRemote in United States
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • 10+ years in healthcare analytics or related fields
  • Proven experience leading strategic initiatives
  • Advanced analytical skills in healthcare data
  • Expert-level proficiency in Microsoft Excel
  • Strong knowledge of CPT/HCPCS coding and reimbursement
  • Exceptional communication and presentation skills
  • Experience influencing senior leaders with data-driven insights
  • Ability to synthesize complex information into actionable recommendations

Responsibilities

  • Lead healthcare analytics initiatives for strategic planning and financial outcomes
  • Analyze complex healthcare datasets to identify trends and opportunities
  • Serve as a trusted advisor to executive leadership
  • Create executive-level presentations and strategic summaries
  • Use advanced Excel skills for financial modeling and data analysis
  • Interpret healthcare utilization and reimbursement data
  • Support contracting analytics for pricing and performance monitoring
  • Collaborate with cross-functional teams for data-driven decisions

Benefits

  • Remote work eligibility with quarterly travel
  • Opportunity to influence organization-wide decision-making
  • Engagement with senior leadership and executive stakeholders
  • Involvement in complex healthcare projects impacting business growth
  • Work in a dynamic environment with a focus on analytics and strategy
Full Job Description
About the Director, Provider Network & Analytics Position:

The Director, Provider Network & Analytics is responsible for leading enterprise-wide analytics initiatives that inform strategic, operational, and financial decision-making across the organization. Serving as a key partner and advisor to executive leadership, this role leverages complex healthcare data, reimbursement methodologies, pricing models, and coding intelligence to deliver actionable insights that drive informed decision-making, advance organizational priorities, and support business growth. The position provides oversight of provider network analytics with a strong focus on laboratory and payer contracting, reimbursement analysis, financial performance evaluation, and network optimization. The Director, Provider Network & Analytics is accountable for developing and implementing data-driven strategies that improve operational efficiency, enhance contract performance, identify revenue opportunities, and support organizational growth. This role requires advanced analytical capabilities, extensive knowledge of healthcare reimbursement and provider network management, and the ability to effectively communicate complex findings and recommendations to executive leaders and key stakeholders.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida, as well as occasional client site visits.

Director, Provider Network & Analytics - Essential Functions and Responsibilities:

  • Lead and oversee complex healthcare analytics initiatives to drive strategic planning, operational performance, and favorable financial outcomes aligned with company objectives.
  • Apply advanced analytical and problemsolving skills to large, complex healthcare datasets, identifying trends and opportunities that inform enterprise decisions.
  • Partner with senior and executive leadership as a trusted analytics advisor, supporting both internal decisionmaking and client engagements, clearly communicating insights, risks, and recommendations.
  • Develop and deliver executivelevel presentations, dashboards, and strategic summaries.
  • Utilize advanced Microsoft Excel skills (including complex formulas, pivot tables, financial modeling, and data analysis) to support contracting, pricing, and reimbursement analytics.
  • Interpret and analyze healthcare utilization, reimbursement, and financial data using CPT coding knowledge, particularly as it relates to laboratory and payer contracts.
  • Support analytics related to healthcare contracting, including pricing analysis, utilization trends, performance monitoring, and margin optimization.
  • Collaborate crossfunctionally with finance, contracting, clinical, and operational teams to ensure datadriven decisionmaking across the organization.
  • Establish best practices for coding and pricing governance, and data quality.


Director, Provider Network & Analytics - Minimum Qualifications:

  • 10+ years of progressive experience in healthcare analytics, provider network management, healthcare contracting, reimbursement analysis, or related healthcare business functions
  • Experience driving strategic initiatives, leading cross-functional teams, and engaging executive stakeholders.
  • Demonstrated advanced analytical and problem-solving capabilities in evaluating healthcare coding, pricing, reimbursement, and claims data to support strategic business decisions.
  • Expert-level proficiency in Microsoft Excel, including financial modeling, data manipulation, and advanced analytical techniques.
  • Strong working knowledge of healthcare claims data, reimbursement analysis, and CPT/HCPCS coding, including the application of coding methodologies to healthcare analytics, reimbursement optimization, pricing strategies, and provider contracting.
  • Exceptional communication and presentation skills, with the ability to effectively influence senior leaders and executive stakeholders through clear, concise, and data-driven insights.
  • Exceptional written and verbal communication skills, with experience producing executivelevel materials and presentations.
  • Proven ability to synthesize and translate complex technical and analytical information into strategic, actionable recommendations for executive leadership and key stakeholders.
  • Demonstrated success leading large-scale analytics initiatives and influencing senior leaders and executive stakeholders to achieve organizational objectives.


Director, Provider Network & Analytics - Preferred Qualifications:

  • Experience supporting healthcare contracting initiatives, particularly involving clinical laboratories, health plans, provider networks, and value-based care arrangements.
  • Strong understanding of healthcare reimbursement methodologies, payer dynamics, contract structures, and performance analytics.
  • Demonstrated experience supporting enterprise-wide, cross-functional healthcare analytics programs involving multiple stakeholders and business units.

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