Data and analytics, specialist/senior specialist (Claims)

Mending•New York, NY

3d•$85,000 - $125,000

About The Position

Mending is seeking a claims-fluent analytical expert to develop its analytics and establish the company as a reference point on Direct Primary Care (DPC) and network benefits. The role uses claims, eligibility, and DPC data from third-party administrators, employers, DPC practices, and health plans to establish benchmarks, create customized insights, and build evidence that supports commercial sales and retention. The position may suit either a senior individual contributor who can recommend next steps independently or someone earlier in their career who can work from directional guidance. The role combines client-facing reporting and analytical storytelling with ownership of internal metrics and analytics, and collaboration with engineering on data models and integrations.

Requirements

At least 4 years of experience for the Specialist level or 6 years for the Senior Specialist level working with healthcare claims and eligibility data.
Experience with 834/835/837 files, PMPM and utilization analysis, and CPT/ICD/NDC codes.
Strong data skills and ability to craft narratives, use SQL to retrieve appropriate data, select appropriate statistical summaries such as median versus mean, and publish results in a BI tool for repeatable use.
Strong understanding of healthcare cost and utilization drivers and ability to benchmark trends, build ROI cases, and recommend actions to benefit leads.
Organized and self-directed across multiple active workstreams.
Comfortable with ambiguity and building processes from scratch.

Nice To Haves

Startup experience.

Responsibilities

Build and maintain client reporting on savings, utilization, PMPM trends, member attachment, and provider engagement across client segments.
Own the internal analytics layer in Metabase and SQL, defining and maintaining consistent metrics and making analytics self-serve across the organization.
Create analytical insights that support sales and retention, including presales ROI models, client-data case studies and benchmarks, and published research on DPC and network benefits.
Partner with engineering on the data model and, over time, ingestion and pipeline work for new TPA and health plan integrations.
Use analytical tools to extract, transform, analyze, visualize, and communicate complex healthcare data.