Payer Analytics Consultant

🔥 48 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

⏰ Full Time

🟠 Senior

🔴 Lead

💼 Consultant

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Abacus Insights

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Abacus Insights is a leader in health plan data solutions that empowers healthcare payers by providing usable and interoperable data. The company offers a comprehensive suite of data solutions designed to address complex government mandates and improve payer readiness. Abacus Insights' platform is capable of consolidating and normalizing diverse data sources into comprehensive patient records, ensuring data accuracy, and facilitating timely data updates. Their solutions support multiple use cases, including risk adjustment, clinical data exchange, cost management, and performance reporting. With a focus on technology and healthcare, Abacus Insights helps payers manage costs and improve member experiences through enhanced data management capabilities.

📋 Description

• Own the analytics workstream on client engagements from scoping and hypothesis development through data modeling, analysis, and delivery of findings • Partner with Payment Integrity and Payer Business Domain consultants to translate client questions into data models, reports, and analyses • Travel onsite to client locations to gather requirements, support live engagements, and build relationships with client stakeholders • Present data findings, dashboards, and analyses directly to client stakeholders, including steering committee updates and working sessions • Design and manage queries and data pipelines in client Snowflake or Databricks environments • Analyze client claims, pharmacy, and provider performance systems • Perform deep-dive analyses of utilization trends, cost drivers, quality metrics, and provider performance • Package findings into clear, presentation-ready outputs • Leverage AI and automation to accelerate analysis, reduce manual reporting, and surface findings • Ensure accuracy, consistency, and technical rigor across client-facing analytics deliverables • Partner with Product, Engineering, and Data teams to scale, automate, and productize analytics workflows and tools • Contribute reusable analytics frameworks, templates, and accelerators to consulting methodologies • Maintain working knowledge of payer domain concepts

🎯 Requirements

• Consulting background at a top-tier global firm or leading healthcare-focused advisory or analytics firm • Typically 3+ years of consulting experience, including client-facing analytics delivery within a healthcare payer practice • 7–10+ years of total hands-on experience in healthcare data analytics • Experience gained at a payer, TPA, health plan vendor, or consulting firm serving them • Hypothesis-driven analysis and structured problem solving • Executive-ready storytelling • Ability to turn ambiguous business questions into structured data models and clear analyses • Deep proficiency in SQL and Power BI and/or Tableau • Track record of building production-grade dashboards and reporting tools • Experience analyzing medical/pharmacy claims, provider performance, or payment integrity data • Strong client-facing communication and presentation skills • Comfort using AI-powered tools for code/query generation and AI-enabled BI features • Willingness and ability to travel onsite to client locations • Working familiarity with claims processing, utilization management, quality measures (HEDIS/STAR), payment integrity, or provider contracting • Bachelor’s degree required • Experience with Python or another scripting language for data manipulation and automation (not required) • Exposure to payment integrity, provider performance/network analytics, cloud data warehouses, or reusable analytics accelerators (not required)

🏖️ Benefits

• Unlimited paid time off • Work from anywhere • Comprehensive health coverage with multiple plan options • Equity for every employee • Growth-focused environment • Home office setup allowance • Monthly cell phone allowance • Eligibility for performance bonuses • Equity grants

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