Sr. Analyst, Health Plan Analytics

Role overview

Senior analyst working across financial planning, healthcare analytics, and population health to turn claims and clinical data into insight about value-based care performance. The role combines data-model ownership, medical economics reporting, financial analysis, and investigative problem-solving. Success requires both the technical ability to build reliable datasets and the judgment to identify when results are incomplete, inconsistent, or misleading.

Responsibilities

- Maintain and improve healthcare payer data models and cost-categorization processes, including new codes, mappings, governance, documentation, and change control. - Build and support medical economics reporting using SQL, Power BI, and Excel, including analysis for incurred-but-not-reported claims, cohort forecasting, and paid-risk pacing. - Review recurring results to identify cost drivers and emerging trends while separating genuine movement from claims lag, statistical noise, or data-quality issues. - Analyze medical-cost changes by unit cost, utilization, and service mix, combining claims with eligibility, electronic health record, provider, and risk-adjustment data. - Partner with finance and medical economics leaders on high-impact analyses, including business cases and return-on-investment assessments for cost initiatives. - Translate questions from clinical, operational, and finance teams into repeatable analyses and communicate conclusions to functional leaders.

Requirements

- Bachelor’s degree in economics, finance, statistics, mathematics, health informatics, actuarial science, or a related quantitative field. - At least three years of experience in healthcare analytics or medical economics within a payer, provider, health system, ACO, or value-based-care setting. - High proficiency in SQL, Power BI, and Excel. - Hands-on experience working with claims data and combining claims, eligibility, clinical, provider, and risk-adjustment sources. - Understanding of healthcare financial and utilization measures such as PMPM, MLR, utilization rates, trend, and risk adjustment. - Ability to document definitions, investigate anomalies, work with evolving datasets, and present data-driven findings clearly.

Nice to have

- Direct experience with value-based-care or medical-economics analytics and claims cost categorization methodologies. - Familiarity with enterprise data platforms such as Palantir Foundry, statistical methods including regression or propensity matching, AI-assisted analytics tools, or cross-functional technical project leadership.

Benefits and work setup

- Paid holidays and paid time off. - Employer-sponsored medical, dental, and vision coverage. - Short- and long-term disability insurance and employer-provided life insurance. - 401(k) plan with a 4% company match and no vesting period. - Annual employer contributions to a Health Savings Account for eligible plans.