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Provider Network Adequacy Analyst Jobs (NOW HIRING)

Georgia

Network Adequacy Manager

Atlanta, GA · On-site

$75K - $100K/yr

Job Title: Network Adequacy Manager Agency: Insurance Department of the State of Georgia Job ... Oversee vendors providing analytical and technical services; validate dashboards, data outputs, and ...

Sonrava Health

Provider Network Manager

Sacramento, CA · Remote

$80K - $85K/yr

Analyze network adequacy and identify strategic recruitment opportunities. * Collaborate with internal departments to ensure an exceptional provider experience and high-quality service. * Minimum of ...

Sonrava Health

Provider Network Manager

Sacramento, CA · Remote

$80K - $85K/yr

Analyze network adequacy and identify strategic recruitment opportunities. * Collaborate with internal departments to ensure an exceptional provider experience and high-quality service.

Sonrava Health

Provider Network Manager

Sacramento, CA · On-site +1

$80K - $85K/yr

Analyze network adequacy and identify strategic recruitment opportunities. * Collaborate with internal departments to ensure an exceptional provider experience and high-quality service.

Grupo Triple-S

Network Operations Analyst

Guaynabo, PR · On-site

This role focuses on evaluating provider network adequacy, access to care, utilization trends, and operational workflows within a healthcare environment. The analyst will design and deliver reports ...

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How much do provider network adequacy analyst jobs pay per hour?

As of Sep 9, 2026, the average hourly pay for provider 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 is a provider network adequacy analyst?

A Provider Network Adequacy Analyst is a professional who evaluates whether a healthcare provider network meets specific access and coverage standards set by regulatory authorities and insurance companies. They analyze data to ensure that patients have sufficient access to healthcare providers, such as doctors and specialists, within reasonable distances and wait times. Their work helps organizations comply with state and federal regulations and ensures that members receive timely and appropriate care.

What are the key skills and qualifications needed to thrive as a provider network adequacy analyst?

To thrive as a Provider Network Adequacy Analyst, you need a strong background in data analysis, healthcare regulations, and provider network management, usually supported by a degree in healthcare administration, public health, or a related field. Familiarity with analytics tools like Excel, SQL, and network adequacy assessment software is typically required, along with knowledge of federal and state compliance standards. Attention to detail, problem-solving, and effective communication are crucial soft skills for interpreting complex data and collaborating with cross-functional teams. These skills ensure the provider network meets regulatory requirements and delivers accessible, high-quality care to members.

What are some typical challenges a provider network adequacy analyst faces in ensuring network compliance?

Provider Network Adequacy Analysts often encounter challenges such as incomplete provider data, rapidly changing regulatory requirements, and difficulties in collecting accurate access information from network providers. Navigating these challenges requires strong analytical skills, attention to detail, and effective communication with both internal teams and external providers. Staying current with state and federal regulations is crucial, as compliance standards can vary significantly between regions and are frequently updated.

What are popular job titles related to Provider Network Adequacy Analyst jobs?

For Provider Network Adequacy Analyst jobs, the most frequently searched job titles are:

Infographic showing various Provider Network Adequacy Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 11% Part Time, and 6% Contract. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $84,100 per year, or $40.4 per hour.

Network Adequacy Manager

Atlanta, GA • On-site

Georgia
See more jobs at Georgiaexternal

$75K - $100K/yr

Full-time

Posted 8 days ago

Job description

Explore a World of Opportunity with the State of Georgia!

We are the force that drives Georgia!
Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of Georgia's more than 10 million citizens!
Join Team Georgia and impact lives everyday while receiving a robust benefits package designed for every stage of your career!

Job Title:

Network Adequacy Manager

Agency:

Insurance Department of the State of Georgia

Job Requisition ID:

JR0000004001

Shift:

Any (United States of America)

Compensation Details:

$75,000 - $100,000

Job Description:

Under supervision, the Network Adequacy Manageris responsible for ensuring issuer compliance with federal and state network adequacy standards, including O.C.G.A. 3320E1 et seq. and Centers for Medicare and Medicaid Services (CMS) requirements under 45 CFR 156.230. This role serves as the State of Georgia's primary authority for network adequacy oversight for Qualified Health Plans (QHP) and offExchange Affordable Care Act (ACA) compliant plans.

Oversee analytical activities, supervises staff and vendor partners, ensures timely and accurate review cycles, identifies issuer performance trends, and provides recurring updates to leadership regarding compliance risks and statewide network sufficiency.

Maintain expert-level knowledge of Georgia-specific network adequacy requirements and align guidance with Centers for Medicare and Medicaid Services (CMS) standards.

Serve as the subject matter expert on federal and state network adequacy regulations, policies, methodologies, and performance metrics.

Interpret Centers for Medicare and Medicaid Services (CMS), Notice of Benefit and Payment Parameters (NBPP), Final Letters to Issuers, NAIC guidance, and regulatory publications to assess statewide impacts.

Review issuer network adequacy submissions and evaluate provider network sufficiency for onExchange and offExchange plans.

Validate issuer justifications for provider network gaps and determine whether deficiencies reflect market constraints or inadequate recruitment.

Produce quarterly and annual adequacy analyses, dashboards, and leadership briefings to identify statewide trends.

Manage the work of assigned analysts responsible for adequacy reviews, compliance tracking, and issuer support.

Oversee vendors providing analytical and technical services; validate dashboards, data outputs, and methodology enhancements.

Coordinate with agency divisions, Centers for Medicare and Medicaid Services (CMS), National Association for Insurance Commissioners (NAIC), and external consultants to ensure operational alignment and timely certification review cycles.

Draft, review, and approve issuer correspondence regarding deficiency notices, corrective action requirements, and compliance determinations.

Establish annual Qualified Health Plans (QHP) certification timelines for adequacy submission review and align with Georgia Access program timelines.

Monitor compliance status and resolution timelines for escalated issuer cases.

Recommend enhancements to templates, procedures, policy guidance, and analytical approaches.

Perform other duties as assigned.

Minimum Qualifications:

Bachelor's degree in a related field from an accredited college or university and three (3) years in a managerial role in the area of assignment; or seven (7) years of experience in the area of assignment, including three (3) years in a managerial role; or one (1) year of experience required at the lower level Mgr 2, Regulatory Compliance (RCM051) or position equivalent.

Equal Employment Opportunity Employer

The State of Georgia does not discriminate based on race, color, national origin, sex, religion, age, disability, or other protected categories in employment or the provision of services.
Qualified applicants may request reasonable accommodation when needed during the application and/or screening process by contacting the appropriate agency Human Resources department.

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