Healthcare Data Analytics Consultant

1 Month ago • 3-5 Years

Job Summary

Job Description

The Payer Analytics Specialist is responsible for analyzing healthcare payer data, creating data pipelines, and managing complex analytics projects. This role involves collaborating with cross-functional teams to ensure robust data integration, reporting, and advanced analytics capabilities. The specialist will develop and maintain data pipelines, analyze data to identify trends, build analytical models, and develop dashboards and reports. They will manage 3rd-party data, ensure data quality, and participate in project management. They must also ensure compliance with regulations, stay updated on industry trends, and mentor junior analysts.
Must have:
  • Develop and maintain end-to-end data pipelines.
  • Analyze data from CPT-level to identify trends.
  • Build and maintain analytical models.
  • Manage 3rd party data from various sources.
  • Ensure compliance with healthcare regulations.
  • Communicate technical concepts to stakeholders.
  • Bachelor’s degree in related field.
  • Proficiency in data pipeline building.
  • Experience with databases and cloud environments.
  • Strong understanding of claims data structures.
Good to have:
  • Experience with healthcare cost transparency regulations.
  • Familiarity with Data Ops or DevOps practices.
  • Certification in BI or data engineering.
  • Experience establishing data stewardship programs.
Perks:
  • Impactful Work
  • Innovation
  • Growth Opportunity
  • Supportive Culture

Job Details

Job Title: Healthcare Data/Payer Analytics Consultant 

Position Summary 

The Payer Analytics Specialist is responsible for driving insights and supporting decision-making by analyzing healthcare payer data, creating data pipelines, and managing complex analytics projects. This role involves collaborating with cross-functional teams (Operations, Product, IT, and external partners) to ensure robust data integration, reporting, and advanced analytics capabilities. The ideal candidate will have strong technical skills, payer domain expertise, and the ability to manage 3rd-party data sources effectively. 

Key Responsibilities 

  1. Data Integration and ETL Pipelines 

  • Develop, maintain, and optimize end-to-end data pipelines, including ingestion, transformation, and loading of internal and external data sources. 

  • Collaborate with IT and Data Engineering teams to design scalable, secure, and high-performing data workflows. 

  • Implement best practices in data governance, version control, data security, and documentation. 

  1. Analytics and Reporting 

  • Data Analysis: Analyze CPT-level data to identify trends, patterns, and insights relevant to healthcare services and payer rates. 

  • Benchmarking: Compare and benchmark rates provided by different health insurance payers within designated zip codes to assess competitive positioning. 

  • Build and maintain analytical models for cost, quality, and utilization metrics, leveraging tools such as Python, R, or SQL-based BI tools. 

  • Develop dashboards and reports to communicate findings to stakeholders across the organization. 

  1. 3rd-Party Data Management 

  • Ingest and preprocess multiple 3rd party data from multiple sources and transform it into unified structures for analytics and reporting 

  • Ensure compliance with transparency requirements and enable downstream analytics. 

  • Design automated workflows to update and validate data, working closely with external vendors and technical teams. 

  • Establish best practices for data quality checks (e.g., encounter completeness, claim-level validations) and troubleshooting. 

  1. Project Management and Stakeholder Collaboration 

  • Manage analytics project lifecycles: requirement gathering, project scoping, resource planning, timeline monitoring, and delivery. 

  • Partner with key stakeholders (Finance, Operations, Population Health) to define KPIs, data needs, and reporting frameworks. 

  • Communicate technical concepts and results to non-technical audiences, providing clear insights and recommendations. 

  1. Quality Assurance and Compliance 

  • Ensure data quality by implementing validation checks, audits, and anomaly detection frameworks. 

  • Maintain compliance with HIPAA, HITECH, and other relevant healthcare regulations and data privacy requirements. 

  • Participate in internal and external audits of data processes. 

  1. Continuous Improvement and Thought Leadership 

  • Stay current with industry trends, analytics tools, and regulatory changes affecting payer analytics. 

  • Identify opportunities to enhance existing data processes, adopt new technologies, and promote data-driven culture within the organization. 

  • Mentor junior analysts and share best practices in data analytics, reporting, and pipeline development. 

Required Qualifications 

  1. Education & Experience 

  • Bachelor’s degree in Health Informatics, Data Science, Computer Science, Statistics, or a related field (Master’s degree a plus). 

  • 3-5+ years of experience in healthcare analytics, payer operations, or related fields. 

  1. Technical Skills 

  • Data Integration & ETL: Proficiency in building data pipelines using tools like SQL, Python, R, or ETL platforms (e.g., Talend, Airflow, or Data Factory). 

  • Databases & Cloud: Experience working with relational databases (SQL Server, PostgreSQL) and cloud environments (AWS, Azure, GCP). 

  • BI & Visualization: Familiarity with BI tools (Tableau, Power BI, Looker) for dashboard creation and data storytelling. 

  • MRF, All Claims, & Definitive Healthcare Data: Hands-on experience (or strong familiarity) with healthcare transparency data sets, claims data ingestion strategies, and provider/facility-level data from 3rd-party sources like Definitive Healthcare. 

  1. Healthcare Domain Expertise 

  • Strong understanding of claims data structures (UB-04, CMS-1500), coding systems (ICD, CPT, HCPCS), and payer processes. 

  • Knowledge of healthcare regulations (HIPAA, HITECH, transparency rules) and how they impact data sharing and management. 

  1. Analytical & Problem-Solving Skills 

  • Proven ability to synthesize large datasets, pinpoint issues, and recommend data-driven solutions. 

  • Comfort with statistical analysis and predictive modeling using Python or R. 

  1. Soft Skills 

  • Excellent communication and presentation skills, with the ability to convey technical concepts to non-technical stakeholders. 

  • Strong project management and organizational skills, with the ability to handle multiple tasks and meet deadlines. 

  • Collaborative mindset and willingness to work cross-functionally to achieve shared objectives. 

Preferred/Additional Qualifications 

  • Advanced degree (MBA, MPH, MS in Analytics, or similar). 

  • Experience with healthcare cost transparency regulations and handling MRF data specifically for compliance. 

  • Familiarity with Data Ops or DevOps practices to automate and streamline data pipelines. 

  • Certification in BI or data engineering (e.g., Microsoft Certified: Azure Data Engineer, AWS Data Analytics Specialty). 

  • Experience establishing data stewardship programs and leading data governance initiatives. 

Why Join Us? 

  • Impactful Work – Play a key role in leveraging payer data to reduce costs, improve quality, and shape population health strategies. 

  • Innovation – Collaborate on advanced analytics projects using state-of-the-art tools and platforms. 

  • Growth Opportunity – Be part of an expanding analytics team where you can lead initiatives, mentor others, and deepen your healthcare data expertise. 

  • Supportive Culture – Work in an environment that values open communication, knowledge sharing, and continuous learning. 

Similar Jobs

Qualcomm - Thermal Engineer

Qualcomm

Santa Clara, California, United States (On-Site)
1 Week ago
bytedance - AI Developer Community Operations Expert

bytedance

(On-Site)
2 Months ago
Travel HR Portal - Senior Insights Analyst (Rail)

Travel HR Portal

London, England, United Kingdom (On-Site)
6 Days ago
Globalization Partners - Benefits Specialist - APAC

Globalization Partners

Malaysia (Remote)
2 Weeks ago
PwC - IFS-Operate-Data Analytics- Manager 2-Kolkata

PwC

Kolkata, West Bengal, India (On-Site)
8 Months ago

Get notifed when new similar jobs are uploaded

Similar Skill Jobs

whoop - Lead Clinical Research Scientist

whoop

Boston, Massachusetts, United States (On-Site)
1 Month ago
Neolytix - Content Writer - US Healthcare Provider Market

Neolytix

Gurugram, Haryana, India (On-Site)
1 Month ago
Philips - Quality Optimization Engineer Lead

Philips

Plymouth, Minnesota, United States (On-Site)
4 Days ago
WaveApps - Technology Operations & Program Manager

WaveApps

Toronto, Ontario, Canada (Remote)
2 Months ago
Netflix - Sales Operations Senior Associate - Revenue Analytics & Insights

Netflix

New York, New York, United States (On-Site)
1 Month ago
Trendyol - Growth Data Analyst

Trendyol

Istanbul, İstanbul, Türkiye (Hybrid)
1 Month ago
GameDuell - Senior Product Manager - Games

GameDuell

Berlin, Berlin, Germany (Hybrid)
1 Month ago
Google - Digital Marketing Strategist

Google

Hyderabad, Telangana, India (On-Site)
1 Month ago
Say games - Marketing Data Analyst

Say games

Limassol, Limassol, Cyprus (Hybrid)
1 Month ago
Advanced Systems Group, LLC - Social Data Analyst

Advanced Systems Group, LLC

New York, New York, United States (On-Site)
1 Month ago

Get notifed when new similar jobs are uploaded

Jobs in Gurugram, Haryana, India

PwC - Senior Associate _SAP BTP Engineering _Advisory corporate _ Advisory_ Bengaluru

PwC

Bengaluru, Karnataka, India (On-Site)
8 Months ago
warner bros games - People & Culture Partner

warner bros games

Hyderabad, Telangana, India (On-Site)
3 Months ago
PwC - Specialist 2

PwC

Gujarat, India (On-Site)
8 Months ago
Autodesk - Site Reliability Engineer

Autodesk

Bengaluru, Karnataka, India (On-Site)
6 Days ago
Capgemini - Connectivity & Network Engineer - B

Capgemini

Bengaluru, Karnataka, India (On-Site)
6 Days ago
Hitachi - Customer Insights (CDP) Consultant

Hitachi

Pune, Maharashtra, India (Remote)
7 Months ago
Cred - Backend Developer - Data Platform

Cred

Bengaluru, Karnataka, India (On-Site)
4 Weeks ago
Highspot - Customer Success Manager, SMB

Highspot

Hyderabad, Telangana, India (Hybrid)
1 Month ago
Hapag-Lloyd AG - Senior Software Engineer

Hapag-Lloyd AG

Chennai, Tamil Nadu, India (On-Site)
6 Months ago
Synechron - Oracle/SQL Developer with IICS (Informatica Intelligent Cloud Services)

Synechron

Bengaluru, Karnataka, India (On-Site)
3 Weeks ago

Get notifed when new similar jobs are uploaded

Similar Category Jobs

Looks like we're out of matches

Set up an alert and we'll send you similar jobs the moment they appear!

About The Company

Pasig, Metro Manila, Philippines (Hybrid)

Chicago, Illinois, United States (On-Site)

Gurugram, Haryana, India (Hybrid)

Chicago, Illinois, United States (Hybrid)

Gurugram, Haryana, India (On-Site)

Chicago, Illinois, United States (Remote)

Chicago, Illinois, United States (On-Site)

Gurugram, India (Hybrid)

Quezon City, Metro Manila, Philippines (Hybrid)

View All Jobs

Get notified when new jobs are added by Neolytix

Level Up Your Career in Game Development!

Transform Your Passion into Profession with Our Comprehensive Courses for Aspiring Game Developers.

Job Common Plug