Senior Consultant, Claims Analytics

We are seeking a Senior Consultant, Claims Analytics to support and lead advanced analytic engagements that help health plans better understand claims data, uncover cost and utilization trends, improve reimbursement accuracy, and enhance operational performance.

Requirements

• 6 to 9+ years of experience in claims analytics, healthcare data analytics, or payer/provider operations with a Bachelor’s degree, or equivalent experience
• Strong experience working with healthcare claims data, including medical and pharmacy datasets
• Proficiency in SQL and experience analyzing large, complex datasets
• Experience with Snowflake, Python, Excel, and Power BI
• Strong understanding of reimbursement methodologies across Medicare, Medicaid, and Commercial lines of business
• Ability to identify trends, anomalies, utilization patterns, and cost drivers in claims data
• Working knowledge of healthcare coding and reimbursement structures including CPT, HCPCS, ICD, DRG, APC, and fee schedules
• Experience with BI tools such as Power BI, Tableau, or similar platforms
• Strong communication skills with ability to translate technical findings into business insights
• Ability to operate independently and manage complex analytical workstreams
• Experience mentoring or supporting junior team members
• Must be legally authorized to work in the United States without employer sponsorship

Benefits

• Flexible PTO
• Monthly half-day refuels
• Volunteer time off
• 10 paid holidays
• Own Your Day flexible work policy
• Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match
• Generous paid parental leave options
• Employer-paid Life Insurance, Short Term Disability, Long Term Disability
• Charitable contribution matching program
• New client commission opportunities and referral bonus program
• Bike share discount program