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Network Adequacy Analyst Jobs (NOW HIRING)

Partner with PPHP

Provider Network Specialist

... network adequacy, market expansion, and provider network objectives. Primary Roles and ... analyze information, identify issues, and follow through on resolution. • Strong attention to ...

Elevance Health

Provider Data Analyst Sr.

Houston, TX · On-site

$78K - $134K/yr

Provider Data Analyst Sr. Provider Data Analyst Sr. Location: This role requires associates to be ... Analyzes network adequacy for changes in the networks. This position will research and address data ...

Elevance Health

Provider Data Analyst Sr.

Las Vegas, NV · On-site

$78K - $134K/yr

Provider Data Analyst Sr. Provider Data Analyst Sr. Location: This role requires associates to be ... Analyzes network adequacy for changes in the networks. This position will research and address data ...

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Network Adequacy Analyst information

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How much do network adequacy analyst jobs pay per hour?

As of Jun 20, 2026, the average hourly pay for network adequacy analyst in the United States is $40.43, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $48.08 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Network Adequacy Analyst, and why are they important?

To thrive as a Network Adequacy Analyst, you need a solid understanding of healthcare networks, data analysis, regulatory requirements, and typically a bachelor’s degree in a related field. Familiarity with data management tools like Excel, SQL, and healthcare compliance systems such as CMS guidelines is often required. Strong attention to detail, analytical thinking, and effective communication skills help you interpret data and collaborate with internal and external stakeholders. These competencies ensure that healthcare provider networks meet regulatory standards and patient access needs, which is critical for organizational compliance and quality care.

What is the difference between Network Adequacy Analyst vs Network Operations Specialist?

AspectNetwork Adequacy AnalystNetwork Operations Specialist
Required CredentialsBachelor's degree, industry certificationsBachelor's degree, relevant certifications
Work EnvironmentHealth insurance companies, managed care organizationsHealthcare providers, insurance companies
Employer & Industry UsagePrimarily in health insurance and managed careIn healthcare networks and provider organizations
Common Search & ComparisonYesNo

The Network Adequacy Analyst focuses on evaluating healthcare provider networks to ensure sufficient access for members, while the Network Operations Specialist manages day-to-day network functions and provider relations. Both roles require industry knowledge and certifications but differ in their primary responsibilities and work settings.

How does a Network Adequacy Analyst collaborate with provider relations and compliance teams to ensure regulatory standards are met?

As a Network Adequacy Analyst, you will frequently work alongside provider relations and compliance teams to assess whether the network meets state and federal requirements for provider access and coverage. This involves analyzing network data, identifying gaps, and coordinating with provider relations to recruit additional providers as needed. You'll also collaborate with compliance teams to interpret evolving regulations and ensure ongoing documentation and reporting align with industry standards. Effective communication and teamwork are essential, as these collaborations help maintain a compliant, high-performing network for members.

What are Network Adequacy Analysts?

Network Adequacy Analysts are professionals who evaluate whether a health insurance provider’s network of doctors, hospitals, and other healthcare providers meets regulatory standards and member needs. They analyze data to ensure that patients have timely and reasonable access to necessary healthcare services within their geographic area. Their work often involves reviewing provider contracts, monitoring compliance with government requirements, and preparing reports for audits or regulatory agencies. Network Adequacy Analysts play a key role in ensuring that health plans remain compliant and that members have access to quality care.
What cities are hiring for Network Adequacy Analyst jobs? Cities with the most Network Adequacy Analyst job openings:
What states have the most Network Adequacy Analyst jobs? States with the most job openings for Network Adequacy Analyst jobs include:
Infographic showing various Network Adequacy Analyst job openings in the United States as of June 2026, with employment types broken down into 1% Internship, 94% Full Time, and 5% Contract. Highlights an 72% In-person, 8% Hybrid, and 20% Remote job distribution, with an average salary of $84,100 per year, or $40.4 per hour.
Health Plan Network Adequacy Analyst III

Health Plan Network Adequacy Analyst III

CareSource

Las Vegas, NV • On-site

$72K - $115K/yr

Full-time

Posted 6 days ago

CareSource rating

7.7

Company rating: 7.7 out of 10

Based on 27 frontline employees who took The Breakroom Quiz

175th of 261 rated insurance

Job description

Job Summary:
The Health Plan Network Adequacy Analyst III reviews and analyzes the effectiveness and efficiency of existing market operation processes and systems, ensures compliance of State and Federal Network Adequacy Standards, and participates in development of solutions to improve or further leverage these functions.
Essential Functions:
  • Manage new and ongoing market network adequacy initiatives from concept to implementation and provide statistics measuring progress throughout.
  • Perform cost-benefit and return on investment analyses for proposed initiatives to aid in the decision-making process; collect and analyze data in support of business case creation and realization.
  • Ensure operational effectiveness by assisting in the development of strategic plans for provider contracts, network adequacy, and network performance, including business, financial, and operational goals and objectives; recognize and manage scope and expected outcomes across the Market to HPLC's strategic initiatives and process improvements.
  • Coordinate with Corporate business areas to conduct network surveys, data, reporting and analysis of all network adequacy standards to include measuring geographic standards, time and distance standards, appointment wait time standards, LTSS standards, and active provider standards.
  • Develop oversight and monitoring processes to include identifying gaps, corrective action and executing upon remediation plans to ensure we comply with all adequacy requirements.
  • Represent and interface as point of contact with regulators as the Network Adequacy Standards Subject Matter Expert to include but not limited to these state agencies: State of Nevada Medicaid, Nevada Health Authority, Department of Insurance.
  • Assist in the review of reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques; prepare and deliver summaries, recommendations, or alternatives of the analyzed information.
  • Work closely with member experience/engagement workgroups and business areas to gather/attain data (to include but not limited to access related grievances and complaints, member calls, out of network claims data), conduct analysis and trends to develop remediation and corrective action plans.
  • Develop, document and perform testing and validation as needed.
  • Challenge the standard thinking with new ideas, approaches, and solutions which focus on process improvement and growth.
  • Perform any other job duties as requested.

Education and Experience:
  • Bachelor's degree in Healthcare, Health Administration, Public Health, Business, Finance, Economics or related field or equivalent years of relevant work experience is required
  • Minimum of five (5) years of experience in managed healthcare, network management or reporting, to include a minimum of three (3) years of health care operations, provider network adequacy, or project management experience is required
  • Experience with provider data repositories and directories preferred

Competencies, Knowledge and Skills:
  • Advanced proficiency in Microsoft Office Suite to include Word, Excel, Access and PowerPoint
  • Familiar with a variety of analysis concepts, practices and procedures
  • Excellent written and verbal communication, facilitation and presentation skills
  • Strong interpersonal skills and high level of professionalism
  • Effective listening and critical thinking skills
  • Effective problem-solving skills with attention to detail
  • Ability to work independently and within a team
  • Strong analytical skills
  • Ability to create and maintain excellent working relationships
  • Time management skills, ability to develop, prioritize and accomplish goals with a sense of urgency
  • Ability to effectively interact with all levels of management within the organization and across multiple organizational layers
  • Ability to multi-task and remain flexible during organizational and/or business changes

Licensure and Certification:
  • None

Working Conditions:
  • General office environment; may be required to sit or stand for long periods of time
  • May be required to travel occasionally
  • Must reside in Nevada

Compensation Range:
$72,200.00 - $115,500.00
CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
  • Fostering a Collaborative Workplace Culture
  • Cultivate Partnerships
  • Develop Self and Others
  • Drive Execution
  • Influence Others
  • Pursue Personal Excellence
  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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