Job Description

Remote Work:
Yes
Job Number:
R0194795
Location:
Washington,DC,US
Health Plan Provider Network Operations Specialist

The Opportunity:  

On our team, you’ll use your analytical skills and data science knowledge to create real-world impact. You’ll work closely with your clients to understand their questions and needs, and then dig into their data-rich environments to find the pieces of their information puzzle. You’ll develop algorithms and systems and use the right combination of tools and frameworks to turn sets of disparate data points into objective answers to help clients make informed decisions. Ultimately, you’ll provide a deep understanding of the data, what it all means, and how it can be used.  

Booz Allen is seeking an experienced health plan data analyst with direct experience in analyses to determine health plan provider network adequacy, provider directory compliance and other various analytic tasks regarding health plan operations. This individual should have a deep understanding of health plan operations. Additionally this individual should understand the data that underlie critical health plan processes, and the strengths and limitations of typical health plan data. Work with us as we use data science for good.  

Join us. The world can’t wait.  

You Have:   

  • 4+ years of experience in a federal, state, or commercial health plan analytics role

  • 4+ years of experience with common data analysis tools including SAS, Python, SQL, or R

  • 3+ years of experience with health insurance claims data

  • Experience with performing health care provider network adequacy analyses for health insurance companies

  • Knowledge of common provider network adequacy evaluation methods including how to establish network adequacy standards and how to evaluate a provider network against established standards

  • Knowledge of the structure of healthcare provider networks and statistical or analytical methods for evaluating network utilization

  • Ability to clean and analyze raw claims and administrative data for trends over time

  • Ability to perform Quality Assurance (QA) reviews of data and analyses

  • Ability to obtain and maintain a Public Trust or Suitability/Fitness determination based on client requirements

  • Bachelor’s degree in Business, Finance, Statistics, Economics, or Public Health

Nice If You Have:   

  • Experience with using ArcGIS, Quest, or similar mapping software for provider network adequacy analyses

  • Experience with the federal procurement process

  • Experience leading teams of analysts

  • Knowledge of industry standards and federal regulations and guidance related to the management of provider networks

  • Knowledge of common data sources for health care provider data such as the Provider Enrollment, Chain, and Ownership System (PECOS), National Plan and Provider Enumeration System (NPPES) and National Provider Identifier (NPI) registry

  • Knowledge of provider credentialing processes

  • Knowledge of provider directories

  • Ability to explain complex analytical methods and data to non-technical audiences in both written and verbal communications 

Vetting:

Applicants selected will be subject to a government investigation and may need to meet eligibility requirements of the U.S. government client.

Create Your Career: 

Grow With Us 

Your growth matters to us—that’s why we offer a variety of ways for you to develop your career. With professional and leadership development opportunities like upskilling programs, tuition reimbursement, mentoring, and firm-sponsored networking, you can chart a unique and fulfilling career path on your own terms.  

A Place Where You Belong 

Diverse perspectives cultivate collective ingenuity. Booz Allen’s culture of respect, equity, and opportunity means that, here, you are free to bring your whole self to work. With an array of business resource groups and other opportunities for connection, you’ll develop your community in no time. 

Support Your Well-Being 

Our comprehensive benefits package includes wellness programs with HSA contributions, paid holidays, paid parental leave, a generous 401(k) match, and more. With these benefits, plus the option for flexible schedules and remote and hybrid locations, we’ll support you as you pursue a balanced, fulfilling life—at work and at home.  

Your Candidate Journey 

At Booz Allen, we know our people are what propel us forward, and we value relationships most of all. Here, we’ve compiled a list of resources so you’ll know what to expect as we forge a connection with you during your journey as a candidate with us.    

Compensation

At Booz Allen, we celebrate your contributions, provide you with opportunities and choices, and support your total well-being. Our offerings include health, life, disability, financial, and retirement benefits, as well as paid leave, professional development, tuition assistance, work-life programs, and dependent care. Our recognition awards program acknowledges employees for exceptional performance and superior demonstration of our values. Full-time and part-time employees working at least 20 hours a week on a regular basis are eligible to participate in Booz Allen’s benefit programs. Individuals that do not meet the threshold are only eligible for select offerings, not inclusive of health benefits. We encourage you to learn more about our total benefits by visiting the Resource page on our Careers site and reviewing Our Employee Benefits page.

Salary at Booz Allen is determined by various factors, including but not limited to location, the individual’s particular combination of education, knowledge, skills, competencies, and experience, as well as contract-specific affordability and organizational requirements. The projected compensation range for this position is $75,600.00 to $172,000.00 (annualized USD). The estimate displayed represents the typical salary range for this position and is just one component of Booz Allen’s total compensation package for employees. This posting will close within 90 days from the Posting Date.

Work Model
Our people-first culture prioritizes the benefits of flexibility and collaboration, whether that happens in person or remotely.

  • If this position is listed as remote or hybrid, you’ll periodically work from a Booz Allen or client site facility.
  • If this position is listed as onsite, you’ll work with colleagues and clients in person, as needed for the specific role.

EEO Commitment

We’re an equal employment opportunity/affirmative action employer that empowers our people to fearlessly drive change – no matter their race, color, ethnicity, religion, sex (including pregnancy, childbirth, lactation, or related medical conditions), national origin, ancestry, age, marital status, sexual orientation, gender identity and expression, disability, veteran status, military or uniformed service member status, genetic information, or any other status protected by applicable federal, state, local, or international law.

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