Payer Analytics Consultant

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Lead the analytics workstream for client projects, encompassing scoping, hypothesis formulation, data modeling, analysis, and the delivery of insights.

• Collaborate with Payment Integrity and Payer Business Domain consultants to convert client inquiries into data models, reports, and analyses.

• Travel to client locations to gather requirements, support live projects, and foster relationships with client stakeholders.

• Deliver data insights, dashboards, and analyses directly to client stakeholders, including updates for steering committees and interactive sessions.

• Design and oversee queries and data pipelines within client Snowflake or Databricks environments.

• Analyze client claims along with pharmacy and provider performance systems.

• Conduct in-depth analyses of utilization trends, cost drivers, quality metrics, and provider performance.

• Present findings in clear, presentation-ready formats.

• Utilize AI and automation to enhance analysis, minimize manual reporting, and highlight findings.

• Ensure precision, consistency, and technical excellence across all client-facing analytics deliverables.

• Collaborate with Product, Engineering, and Data teams to scale, automate, and develop analytics workflows and tools.

• Contribute to reusable analytics frameworks, templates, and accelerators within consulting methodologies.

• Maintain an up-to-date understanding of payer domain concepts.

⛳️ Requirements

• Consulting experience from a top-tier global firm or a leading healthcare-focused advisory or analytics organization.

• Generally, 3+ years of consulting experience, particularly in client-facing analytics delivery within a healthcare payer practice.

• 7–10+ years of overall hands-on experience in healthcare data analytics.

• Experience acquired at a payer, TPA, health plan vendor, or a consulting firm that serves them.

• Proficiency in hypothesis-driven analysis and structured problem-solving.

• Ability to craft executive-level storytelling.

• Capacity to translate ambiguous business questions into structured data models and clear analyses.

• Advanced skills in SQL and Power BI and/or Tableau.

• Proven history of developing production-grade dashboards and reporting tools.

• Experience in analyzing medical/pharmacy claims, provider performance, or payment integrity data.

• Strong communication and presentation skills for client-facing interactions.

• Comfort with AI-powered tools for code/query generation and AI-enhanced BI features.

• Willingness and capability to travel to client locations as needed.

• Familiarity with claims processing, utilization management, quality measures (HEDIS/STAR), payment integrity, or provider contracting.

• Bachelor’s degree is mandatory.

• Knowledge of Python or another scripting language for data manipulation and automation is a plus (not required).

• Exposure to payment integrity, provider performance/network analytics, cloud data warehouses, or reusable analytics accelerators is a plus (not required).

🏝️ Benefits

• Unlimited paid time off.

• Flexibility to work from anywhere.

• Comprehensive health coverage with various plan options.

• Equity offered to every employee.

• Environment focused on growth.

• Allowance for home office setup.

• Monthly cell phone allowance.

• Eligibility for performance-related bonuses.

• Equity grants.