Sr. Analyst, Network Strategy, Pricing & Analytics
Umpqua Health, Roseburg, OR, United States
Position Purpose
The Senior Analyst, Network Strategy, Pricing & Analytics provides advanced financial and data analysis to guide network investment decisions and ensure access to high‑quality, cost‑effective healthcare services. This role supports Umpqua Health’s mission by developing pricing strategies, evaluating provider contracts, and leveraging value‑based care models to improve health outcomes and reduce total cost of care. The position requires expertise in healthcare economics, contract valuation, predictive analytics, and strategic reporting to identify opportunities for cost savings and performance improvement.
Essential Job Responsibilities
Conduct analysis of provider performance, utilization trends, and geographic coverage to identify network gaps, inefficiencies, and opportunities for optimization.
Develop and apply predictive models to assess contract risk, forecast financial impact, and evaluate provider behavior under varying reimbursement methodologies.
Interpret contract rates, terms, and coding structures to assess financial implications and support contract negotiation strategies, including chargemaster considerations.
Ensure the integrity and accuracy of integrated claims, provider, and contract data; identify and resolve data quality issues impacting reporting and analysis.
Support compliance with applicable regulatory requirements through data monitoring, audit support, and required reporting.
Design, develop, and maintain dashboards, reports, and data visualizations to effectively communicate insights to internal stakeholders.
Prepare and deliver recurring provider and hospital performance reports utilizing SQL, Excel, and other reporting tools.
Present analytical findings and strategic recommendations to leadership in a clear, concise, and professional manner.
Apply statistical and machine learning methodologies to address complex business challenges, including fraud detection and provider performance trends.
Collaborate with cross‑functional teams to align data initiatives with organizational priorities and strategic objectives.
Identify and support process improvements related to data collection, reporting, and analytics functions.
Qualifications, Knowledge, Skills, and Abilities Minimum Qualifications
Bachelor’s degree in business, finance, mathematics, economics, data science, actuarial science, or a related field.
Minimum of five (5) years of experience in analytics, including financial analysis, healthcare pricing, network management, or healthcare economics.
Advanced proficiency in Microsoft Excel and strong working knowledge of SQL.
Experience working with complex data environments, including database management and performance analytics.
Proficiency in at least one programming or analytics language (e.g., Python or R) and experience with data visualization tools (e.g., Tableau or Power BI).
Working knowledge of statistical modeling and analytical methodologies.
Strong written and verbal communication skills, including the ability to present technical information to non‑technical audiences.
Demonstrated ability to work independently and collaboratively in a cross‑functional environment.
Preferred Qualifications
Master’s degree in data science, statistics, computer science, health informatics, or a related field.
Experience in healthcare, insurance, or network management analytics.
Advanced expertise in statistical modeling, machine learning, and experimental design.
Extensive familiarity with healthcare data sources, including claims, provider data, and contract information.
Equal Employment Opportunity UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship.
UH makes hiring decisions based solely on qualifications, merit, and business needs at the time.
About Umpqua Health At Umpqua Health, we're more than just a healthcare organization; we're a community‑driven Coordinated Care Organization (CCO) committed to improving the health and well‑being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high‑quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.
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Essential Job Responsibilities
Conduct analysis of provider performance, utilization trends, and geographic coverage to identify network gaps, inefficiencies, and opportunities for optimization.
Develop and apply predictive models to assess contract risk, forecast financial impact, and evaluate provider behavior under varying reimbursement methodologies.
Interpret contract rates, terms, and coding structures to assess financial implications and support contract negotiation strategies, including chargemaster considerations.
Ensure the integrity and accuracy of integrated claims, provider, and contract data; identify and resolve data quality issues impacting reporting and analysis.
Support compliance with applicable regulatory requirements through data monitoring, audit support, and required reporting.
Design, develop, and maintain dashboards, reports, and data visualizations to effectively communicate insights to internal stakeholders.
Prepare and deliver recurring provider and hospital performance reports utilizing SQL, Excel, and other reporting tools.
Present analytical findings and strategic recommendations to leadership in a clear, concise, and professional manner.
Apply statistical and machine learning methodologies to address complex business challenges, including fraud detection and provider performance trends.
Collaborate with cross‑functional teams to align data initiatives with organizational priorities and strategic objectives.
Identify and support process improvements related to data collection, reporting, and analytics functions.
Qualifications, Knowledge, Skills, and Abilities Minimum Qualifications
Bachelor’s degree in business, finance, mathematics, economics, data science, actuarial science, or a related field.
Minimum of five (5) years of experience in analytics, including financial analysis, healthcare pricing, network management, or healthcare economics.
Advanced proficiency in Microsoft Excel and strong working knowledge of SQL.
Experience working with complex data environments, including database management and performance analytics.
Proficiency in at least one programming or analytics language (e.g., Python or R) and experience with data visualization tools (e.g., Tableau or Power BI).
Working knowledge of statistical modeling and analytical methodologies.
Strong written and verbal communication skills, including the ability to present technical information to non‑technical audiences.
Demonstrated ability to work independently and collaboratively in a cross‑functional environment.
Preferred Qualifications
Master’s degree in data science, statistics, computer science, health informatics, or a related field.
Experience in healthcare, insurance, or network management analytics.
Advanced expertise in statistical modeling, machine learning, and experimental design.
Extensive familiarity with healthcare data sources, including claims, provider data, and contract information.
Equal Employment Opportunity UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship.
UH makes hiring decisions based solely on qualifications, merit, and business needs at the time.
About Umpqua Health At Umpqua Health, we're more than just a healthcare organization; we're a community‑driven Coordinated Care Organization (CCO) committed to improving the health and well‑being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high‑quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.
#J-18808-Ljbffr