Payer Analytics Consultant

Own the analytics workstream on client engagements with health plans, translating business questions into rigorous analysis, data models, dashboards, and practical recommendations. This individual contributor role combines hands‑on work in client data environments with direct presentations and relationship-building; travel to client sites is estimated at about 25%.

• Scope analytics engagements, develop hypotheses, model data, conduct analysis, and present findings.
• Work with payment integrity and payer‑domain specialists to turn client questions into useful reports and analyses.
• Gather requirements onsite and present results in working sessions and steering committee updates.
• Build and manage queries and data pipelines in client Snowflake or Databricks environments, using claims, pharmacy, and provider performance data.
• Investigate utilization, cost, quality, and provider performance, then create clear, presentation‑ready outputs.
• Use AI and automation to speed analysis and reporting, and help product, engineering, and data teams scale reusable workflows and consulting tools.

• 7–10+ years of hands‑on healthcare data analytics experience at a payer, third‑party administrator, health‑plan vendor, or consulting firm serving these organizations.
• Typically 3+ years in client‑facing analytics consulting at a major global consultancy or healthcare‑focused advisory or analytics firm.
• Strong SQL and Power BI and/or Tableau skills, including production‑quality dashboards and reporting.
• Experience analyzing medical or pharmacy claims, provider performance, or payment integrity data.
• Structured, hypothesis‑driven problem solving and the ability to turn ambiguous questions into clear analysis and executive‑ready stories.
• Strong client presentation skills, with confidence explaining results and answering questions live.

The role includes onsite client travel estimated at approximately 25%.

The source also expects familiarity with payer topics such as claims, utilization management, quality measures, payment integrity, and provider contracting.