About The Position

The Health Utilization Management Analytics (HUMA) team is seeking a senior individual contributor to lead analytics for the Transparency initiative—a high‑visibility effort supporting executive commitments, regulatory requirements, and strategic decision making related to UM programs. This role is ideal for a seasoned healthcare analytics professional with strong quantitative judgment, methodological rigor, and an actuarial‑minded approach to trend analysis, assumptions, and credibility. The advisor will serve as the analytical lead for Transparency, owning methodology, metrics, and interpretation, while partnering closely with Medical Directors and enterprise stakeholders to ensure insights are clear, defensible, and actionable.

Requirements

  • Several years of experience applying advanced analytics in healthcare, with strong knowledge of utilization management and healthcare data (e.g., claims, ICD‑10)
  • Demonstrated experience with trend analysis, forecasting, program evaluation, and comparative or matched analyses
  • Proven ability to develop defensible methodologies and clearly communicate assumptions, limitations, and implications
  • Strong data visualization and storytelling skills; ability to influence senior stakeholders through analytical credibility (Tableau experience preferred)
  • If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload

Nice To Haves

  • Actuarial training, exams, or experience working closely with actuarial teams is highly desired

Responsibilities

  • Own the end‑to‑end analytical strategy for Transparency, including metric definition, methodology design, execution, documentation, and refinement for all non-delegated authorization experience
  • Develop and defend analytical logic supporting external transparency commitments, regulatory needs, and internal leadership decisions
  • Perform advanced utilization, trend, and comparative analyses to assess UM program performance and future opportunities
  • Apply sound analytical judgment to address data limitations, assumptions, uncertainty, and credibility
  • Translate complex findings into clear, decision‑focused insights for senior leaders and clinical stakeholders
  • Partner closely with Medical Directors, clinical leaders, and cross‑functional teams to ensure analyses reflect clinical and business context
  • Support additional Health Utilization Management Analytics initiatives as needed

Benefits

  • Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
  • We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
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