Senior Analyst, Health Plan Analytics
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Job Description
Senior analyst building claims models and medical economics reporting for Hopscotch Primary Care. Turning healthcare data into insights that improve value-based care in rural communities.
Responsibilities:
- Support the in-house build of Hopscotch’s cost categorization capability, including customizations, new code and mappings, and change management
- Own maintenance, enhancements, governance, change control, and documentation for payer data and cost categorization capabilities
- Build and maintain the medical economics reporting suite using SQL, Power BI, and Excel
- Support IBNR estimation, cohort forecasting, and paid-risk pacing
- Review monthly outputs to surface cost drivers and emerging trends, distinguishing real movement from incomplete claims and statistical noise
- Analyze medical cost trends across unit cost, utilization, and mix
- Enrich claims with EHR, eligibility, provider, and risk adjustment data to explain population-level trends and financial performance
- Partner with medical economics and finance leadership on high-impact analyses, including pro forma and ROI for medical cost initiatives
- Collaborate with Clinical, Operations, and Finance to translate business questions into analyses
- Ensure results flow accurately into management reporting and build repeatable analytic processes that scale across programs
Requirements:
- Bachelor's in Economics, Finance, Statistics, Mathematics, Health Informatics, Actuarial Science, or a related quantitative field
- 3+ years of experience in healthcare analytics or medical economics (payer, provider, health system, ACO, or VBC)
- High proficiency in SQL, Power BI, and Excel
- Hands-on experience with healthcare claims data, and combining data sources (claims, eligibility, EHR, risk adjustment)
- Familiarity with healthcare financial and utilization concepts (e.g., PMPM, MLR, utilization per 1,000, trend, risk adjustment)
- Experience with maturing data models, identifying improvement opportunities while still generating value from nascent datasets
- Experience presenting and communicating data-driven insights to functional leaders
- Preferred / Bonus: Direct value-based care / medical-economics analytics experience and familiarity with claims cost categorization methodologies
- Preferred / Bonus: Experience with Palantir Foundry or a comparable enterprise data platform
- Preferred / Bonus: Comfort using AI-assisted tooling
- Preferred / Bonus: Statistical methods including regression, difference-in-differences, and propensity score matching
- Preferred / Bonus: Experience leading technical/analytical projects with functional and technical stakeholders
Benefits:
- Paid holidays + PTO
- Company sponsored medical, dental, and vision insurance for you + your family
- FREE short-term and long-term disability insurance
- FREE $100k life insurance policy
- 401k plan with 4% company match + no vesting period
- $720 - $1,000 added to employee Health Savings Account annually for eligible health plans
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