Senior Business and Data Analyst

Abacus Insights

4h•Remote

About The Position

Abacus Insights is seeking an experienced Business and Data Analyst to connect clients’ business needs with data solutions. The role owns requirements and analysis for assigned use cases and workstreams, combining healthcare business knowledge with hands-on data analysis. It is client-facing and involves translating healthcare challenges into testable requirements, using SQL and analytical judgment to assess data, and shaping evidence-based designs in partnership with Business Solution Managers and delivery teams. The analyst works with US health plans and their partners across Medicare, Medicaid, and Commercial lines of business. Engagements may involve standardizing and migrating data to a new platform, meeting regulatory and compliance requirements, or supporting analytics and reporting programs. The role also calls for systems thinking: identifying opportunities to reuse designs across clients, states, and use cases, and flagging dependencies or potential downstream impacts. The position collaborates with client stakeholders and internal teams, including Solution Architects, Product, QA, Account Management, and Program Management. The Business Solution Manager owns the overall client relationship, while the analyst represents client intent for their use cases and serves as a day-to-day contact for those workstreams.

Requirements

Bachelor's degree or equivalent relevant experience.
At least 5 years of experience in the US healthcare domain and with healthcare data, such as claims, provider, membership/eligibility, benefits, prior authorization, or PBM data.
Direct experience working with or for a US health plan in Medicare, Medicaid, or Commercial, either in-house or through healthcare consulting.
Working command of payer concepts including membership/enrollment, provider, claims, and authorizations.
Strong, hands-on SQL skills, including joins across large multi-table datasets, window functions, CTEs, aggregations, and date/span logic; regular use for profiling, validation, reconciliation, and analysis.
Demonstrated analytical rigor, including data profiling, data quality assessment, root-cause investigation, and communication of quantified findings that informed decisions.
Experience defining metrics, mentoring junior analysts, and eliciting and authoring business requirements in complex, data-driven environments.
Confident client-facing communication skills, including driving conversations, eliciting requirements, and presenting findings to technical and non-technical audiences.
Ability to work with ambiguity, reprioritize frequently, and manage multiple use cases within a larger engagement.
Experience designing for reuse and scale across states, clients, or use cases, and tracing how requirements or data-model decisions affect a broader data ecosystem.

Nice To Haves

Exposure to Databricks or Snowflake.
Background blending business analysis with hands-on data work, such as Business Analyst, Data Analyst, or Business Data Analyst experience, including client-facing delivery.
Experience with BI and visualization tools such as Tableau, Power BI, or similar.
Familiarity with HEDIS and Stars quality reporting, risk adjustment, payment integrity, value-based care analytics, provider data management, or CMS interoperability (CMS-0057).
Working knowledge of data modeling concepts, including how dataset grain and structure shape downstream use.
Familiarity with Python or similar tools for analysis and automation.
Familiarity with Medicaid data or PBM platforms.

Responsibilities

Write and execute SQL to profile source data, test assumptions, quantify data quality, and prototype logic.
Assess source data availability and reliability, including field populations and distributions, key integrity, duplicates, outliers, and gaps relative to business needs.
Reconcile outputs against source systems and client benchmarks; investigate variances to root cause and document findings.
Define business metrics and KPIs, including numerator, denominator, inclusion and exclusion logic, time basis, and grain.
Perform exploratory and root-cause analysis on client questions and data anomalies, then provide quantified recommendations.
Communicate findings through data profiling reports, analysis readouts, and visualizations for technical and non-technical stakeholders.
Lead discovery sessions for assigned use cases and support broader engagement sessions with the Business Solution Manager.
Translate use cases into clear, testable requirements, success criteria, and non-functional requirements; maintain traceability from business need through requirement, design, and test.
Use data analysis to validate and refine requirements and surface data gaps early.
Document source-to-target mappings, transformation logic, business rules, test conditions, and expected results.
Recommend dataset grain and structure based on business context and assess effects on downstream reports, models, and programs.
Identify dependencies across workstreams, reports, and client use cases; escalate cross-workstream impacts to the Business Solution Manager.
Recognize and promote reusable design patterns across clients, states, and use cases.
Gather and clarify requirements with client subject-matter experts, present findings and recommendations, and guide decisions with evidence.
Represent client intent for assigned use cases through delivery and serve as a day-to-day point of contact, while the Business Solution Manager owns the overall client relationship.
Translate between business and technical audiences to maintain a shared understanding.
Provide Solution Architects, Product, QA, Account Management, and Program Management with business context, rules, analysis, and clear hand-offs.
Support QA and UAT with validation queries, expected results, variance analysis, and defect triage.
Monitor how decisions in one workstream may affect others and flag potential impacts before they cause rework.