Manager, Claims Analytics

We're seeking a Manager, Claims Analytics to lead analytic workstreams that help health plans better understand their claims data, uncover cost and utilization trends, improve reimbursement accuracy, and enhance overall operational performance.

Requirements

• 7+ years of experience in claims analytics, healthcare data analytics, actuarial analysis, or payer/provider operations with a Bachelor’s Degree, or 11+ years of equivalent experience
• Demonstrated experience leading project teams or mentoring analysts and consultants
• Strong experience analyzing healthcare claims datasets, including medical and pharmacy
• Understanding of reimbursement methodologies across Medicare, Medicaid, Commercial, and other lines of business
• Proficiency in SQL or similar query languages used to analyze complex datasets
• Ability to identify trends, anomalies, utilization patterns, and cost drivers within 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 Qlik
• Strong communication skills with ability to explain analytic findings clearly
• Advanced proficiency in Excel or equivalent data tools
• Knowledge of payer operations, provider contracting concepts, and healthcare financial analysis

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