Design and maintain sophisticated claims analytics models that track medical cost trends, utilization patterns, and financial performance across the member population
Partner directly with CEO and executive leadership to provide proactive claims analysis, identifying emerging trends 30-60 days before they become critical issues
Build self-service analytics platforms and automated reporting solutions that enable stakeholders across the organization to access claims insights without bottlenecking through a single analyst
Translate complex claims data into executive-ready presentations and recommendations that inform strategic decisions on cost management, network strategy, and member experience
Architect scalable data infrastructure using DBT, SQL, and modern analytics tools that can grow 10x without requiring fundamental rework
Proactively identify opportunities to leverage AI, automation, and new technologies to improve analytics efficiency and insight quality
Serve as subject matter expert on claims methodology, regulatory requirements, and industry best practices
Requirements
8+ years of experience in healthcare analytics with deep expertise in claims analysis and medical cost/trend modeling
Background in health insurance or payer organizations with proven experience leading claims analytics functions or building claims models handling significant volume
Advanced SQL skills with ability to design complex data models, optimize query performance, and architect data transformation pipelines
Hands-on experience with DBT for data transformation and modern dashboarding tools (Tableau, Looker, or similar)
Demonstrated track record of delivering analytics that directly informed C-suite or executive-level business decisions
Experience building self-service analytics solutions or platforms that enable organizational scale
Benefits
Medical / Dental / Vision insurance
Flexible Spending Account
Health Savings Account + match
Company paid STD/LTD, AD&D, and Life insurance
Paid Family Leave
401K + match
Paid Time Off
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.