Senior Consultant, Health Care Data Analytics

• Design, develop, automate, maintain, and execute client-facing and internal dashboards, reports, scorecards, and recurring analytics supporting value-based care initiatives.

• Translate client and stakeholder business requirements into scalable reporting and analytical solutions using SMSS SQL, Excel, and other business intelligence tools.
• Analyze healthcare claims, EMR, and operational datasets to identify actionable opportunities related to quality performance, care management, utilization management, prior authorization, HCC risk adjustment, population health, and medical cost/utilization.
• Develop executive-ready reporting that highlights operational efficiencies, outcomes, successes, failures, emerging trends, and strategic opportunities.

• Validate healthcare data for completeness, accuracy, consistency, and adherence to business rules while ensuring reporting integrity and reproducibility.

• Collaborate with product, engineering, consulting, and implementation teams to map client-specific data elements and define reporting logic aligned with client requirements.

• Investigate data anomalies, perform root cause analyses, and recommend solutions that improve data quality and accurate reporting.

• Support implementation of new reporting capabilities for value-based care programs including MSSP, ACO REACH, Medicare Advantage, Commercial Risk, and Medicaid value-based arrangements.

• Present analytical findings to both technical and executive audiences in a clear, actionable manner.

• Utilize AI-enabled technologies to accelerate report development, optimize SQL coding, improve documentation, automate repetitive analytical processes, and identify innovative opportunities for enhancing client value.

• Contribute to continuous improvement initiatives that modernize analytics capabilities, increase operational efficiency, and strengthen consulting delivery.

• Review or quality oversight of junior team members.

• Project leadership or information mentorship.

Qualifications

• Graduate degree with a quantitative, healthcare, business or technical focus preferred, bachelor’s degree and applicable experience will be considered.

• 3+ years of professional experience performing healthcare analytics within a consulting firm, health system, payer, accountable care organization, or healthcare technology organization.

• Demonstrated experience working with healthcare claims and eligibility data (professional, institutional, and pharmacy).

• Experience with Electronic Medical Record (EMR/HER) and Utilization Management and Prior Authorization datasets preferred

• Proficiency in SQL

• Familiarity of data visualization and Business Intelligence platforms

• Working knowledge of value-based care programs and healthcare risk-based arrangements including MSSP, ACO REACH, Medicare Advantage, and alternative payment models.

• Experience supporting HCC Risk Adjustment, quality, care management reporting, and utilization management analytics.

• Strong consulting, project management, and stakeholder relationship management skills.

• Experience utilizing AI technologies (e.g., ChatGPT, Microsoft Copilot, Claude, GitHub Copilot, or similar tools) to improve analytics development, SQL optimization, reporting automation, and operational efficiency.

• Excellent written and verbal communication skills with the ability to explain technical concepts to both technical and business audiences.