Role Overview
- Financial Modeling & Forecasting
- Develop drivers-based forecasts for claims, A&G, enrollment volumes and staffing
- Model unit costs: labor minutes, variable non-labor (print/postage), and platform allocations
- Business Case & ROI
- Quantify automation impacts (minutes saved, FPY lift, re-touch reduction)
- Create sensitivity scenarios; track actuals vs. plan in a benefits dashboard
- Data & Analytics
- Define telemetry, cost attribution, and allocation methodologies
- Partner with Data/IT to build reliable data pipelines and BI views
- Governance & Reporting
- Own monthly/quarterly performance readouts; support audits and compliance reporting
Requirements
- Payer finance or healthcare analytics experience with strong Excel/SQL/BI
- Forecasting/statistics familiarity (time series, regression) and scenario modeling
- Ability to tie operational metrics (FPY, SLA, rework) to P&L outcomes
- Executive storytelling and stakeholder management
- Compliance: Working knowledge of HIPAA Privacy/Security, PHI/PII handling, audit readiness, data governance.
- Techno-Functional: Ability to translate business needs into technical designs across cloud, data, APIs, and interoperability.
- GenAI/Analytics: Practical experience with GenAI solutioning (e.g., RAG, prompt engineering, evaluation) and classical analytics (segmentation, anomaly detection).
- Cloud/Data Tools: Exposure to Azure/AWS/GCP, Snowflake/Databricks/BigQuery, SQL/PySpark, ETL/ELT (ADF/Glue), APIs (REST/GraphQL), Kafka, Tableau, Power BI.
- Consulting & BA: Proven proposal/RFP experience, SOW/MSA inputs, stakeholder management, requirements elicitation, UAT planning.
Tech Stack
- AWS
- Azure
- BigQuery
- Cloud
- ETL
- Google Cloud Platform
- GraphQL
- Kafka
- PySpark
- SQL
- Tableau
Benefits
Health insurance
401(k) matching
Flexible work hours
Paid time off
Remote work options