Senior Analyst, Health Plan Analytics

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

📋 Description

• Assist in the internal development of Hopscotch’s cost categorization functionality, including custom modifications, new coding, mappings, and change management.

• Take ownership of the maintenance, enhancements, governance, change control, and documentation for payer data and cost categorization functionalities.

• Develop and sustain the medical economics reporting suite utilizing SQL, Power BI, and Excel.

• Provide support for IBNR estimation, cohort forecasting, and paid-risk pacing.

• Analyze monthly outputs to identify cost drivers and emerging trends, differentiating genuine movements from incomplete claims and statistical anomalies.

• Evaluate medical cost trends across unit costs, utilization, and service mix.

• Augment claims data with EHR, eligibility, provider, and risk adjustment information to clarify population-level trends and financial performance.

• Collaborate with medical economics and finance leadership on impactful analyses, including pro forma and ROI evaluations for medical cost initiatives.

• Work in partnership with Clinical, Operations, and Finance teams to convert business inquiries into analytical insights.

• Ensure accurate integration of results into management reporting and develop repeatable analytical processes that can scale across various programs.

⛳️ Requirements

• Bachelor’s degree in Economics, Finance, Statistics, Mathematics, Health Informatics, Actuarial Science, or a related quantitative discipline.

• Over 3 years of experience in healthcare analytics or medical economics (payer, provider, health system, ACO, or VBC).

• Advanced proficiency in SQL, Power BI, and Excel.

• Practical experience with healthcare claims data, including the integration of diverse data sources (claims, eligibility, EHR, risk adjustment).

• Understanding of healthcare financial and utilization concepts (e.g., PMPM, MLR, utilization per 1,000, trend analysis, risk adjustment).

• Experience in advancing data models, identifying areas for improvement while still deriving value from early-stage datasets.

• Proven experience in presenting and communicating data-driven insights to functional leaders.

• Preferred / Bonus: Direct experience in value-based care / medical-economics analytics and knowledge of claims cost categorization methodologies.

• Preferred / Bonus: Familiarity with Palantir Foundry or a similar enterprise data platform.

• Preferred / Bonus: Comfort with AI-assisted tools.

• Preferred / Bonus: Knowledge of statistical methods including regression, difference-in-differences, and propensity score matching.

• Preferred / Bonus: Experience leading technical and analytical projects with both functional and technical stakeholders.

🏝️ Benefits

• Paid holidays and PTO.

• Company-sponsored medical, dental, and vision insurance for you and your family.

• FREE short-term and long-term disability insurance.

• FREE $100k life insurance policy.

• 401k plan with a 4% company match and no vesting period.

• Annual contribution of $720 - $1,000 to the employee Health Savings Account for eligible health plans.