Payer Analytics Consultant

Abacus Insights•Boston, MA

3d•Remote

About The Position

Abacus Insights is seeking a Payer Analytics Consultant to serve as the dedicated data and analytics partner working side-by-side with our business teams and client teams as we launch new and expanded service offerings for health plans. This is a client-facing subject matter expert role focused on payment integrity, provider performance, and payer operations — turning client questions into the data models, dashboards, and analyses that power their recommendations, leveraging AI and automation wherever it helps you move faster and dig deeper. In this role, you will travel onsite to client locations alongside other members of the team, gathering requirements in person, presenting your own analysis to client stakeholders, and building the kind of trusted relationships that come from being in the room. This is an individual-contributor, analytics-first role: you are both the technical engine that makes our insights possible, accurate, and repeatable, and a visible, credible voice in front of clients yourself. You’ll help set the standard for how Abacus delivers analytics to health plans as these new offerings take off. This role sits at the intersection of payer domain knowledge, hands-on data analytics, and client delivery.

Requirements

7–10+ years of hands-on experience in healthcare data analytics — gained at a payer, TPA, health plan vendor, or consulting firm serving them
Deep proficiency in SQL and Power BI and/or Tableau, with a track record of building production-grade dashboards and reporting tools
Experience analyzing medical/pharmacy claims, provider performance, or payment integrity data
Comfort translating ambiguous business questions into structured data models and clear analyses
Strong client-facing communication and presentation skills — comfortable presenting analysis directly to client stakeholders and fielding questions in real time, not just supporting consultants behind the scenes
Comfort using AI-powered tools (e.g., Copilot-style assistants, GenAI for code/query generation, AI-enabled BI features) to work faster and surface insights more efficiently
Willingness and ability to travel onsite to client locations as part of a consulting engagement team
Working familiarity with payer domain concepts: claims processing, utilization management, quality measures (HEDIS/STAR), payment integrity, or provider contracting

Nice To Haves

Experience with Python or another scripting language for data manipulation and automation
Exposure to payment integrity specifically — claims auditing, fraud/waste/abuse detection
Exposure to provider performance or network analytics
Experience with cloud data warehouses (e.g., Snowflake, Databricks, Redshift, BigQuery)
Master’s degree in a quantitative field, Public Health, or a related discipline

Responsibilities

Partner closely with Abacus’ Payment Integrity and Payer Business Domain consultants, translating their client questions into data models, reports, and analyses that support their recommendations
Travel onsite to client locations alongside the consulting team to gather requirements, support live engagements, and build direct relationships with client stakeholders
Present data findings, dashboards, and analyses directly to client stakeholders — translating technical analysis into clear, actionable takeaways in real time
Design and manage the queries and data pipelines — working directly inside each client’s own Snowflake or Databricks environment — that pull from client claims, pharmacy, and provider performance systems to support active consulting engagements
Perform deep-dive analyses — utilization trends, cost drivers, quality metrics, provider performance — and package findings into clear, presentation-ready outputs for consultants and clients alike
Leverage AI and automation — from AI-assisted query generation to GenAI-powered insight summarization — to accelerate analysis, reduce manual reporting work, and surface findings faster for consultants and clients
Ensure data accuracy, consistency, and technical rigor across all client-facing analytics deliverables
Partner with Product, Engineering, and Data teams to scale, automate, and productize the analytics workflows and tools the consulting team relies on
Maintain working knowledge of payer domain concepts — claims, utilization management, quality measures, payment integrity, and provider contracting — so analytics outputs are accurate and meaningfully interpreted