Senior Healthcare Data Analyst, Health Plan Strategy
About The Position
This is a hands-on healthcare analytics role for someone who can turn complex medical, pharmacy, clinical, financial, and eligibility data into meaningful insights and recommendations. You’ll analyze what’s driving healthcare costs and utilization, forecast future trends, evaluate programs and vendor performance, and identify opportunities to improve employee health outcomes while managing total healthcare spend. Working closely with Benefits leadership and our Wonderful Wellness Centers, you’ll help connect data to decisions across health plan design, clinical programs, vendor strategy, and long-term healthcare planning. This is a senior individual-contributor role with significant visibility and the opportunity to influence strategy through analytics, project leadership, and cross-functional partnership.
Requirements
- 4+ years of healthcare data analytics experience working with medical and/or pharmacy claims data.
- Hands-on experience analyzing large healthcare datasets and identifying cost, utilization, and performance trends.
- Proficiency with SQL and experience with reporting or visualization tools such as Power BI, Tableau, or SSRS.
- Experience with financial modeling, forecasting, trend analysis, or healthcare cost analysis.
- Strong understanding of healthcare cost and utilization drivers with the ability to translate analysis into business recommendations.
- Experience communicating complex findings to non-technical stakeholders and senior leaders.
- Bachelor’s degree in a related field.
Nice To Haves
- Experience analyzing healthcare claims or plan performance for self-funded employer populations.
- Experience within a self-funded employer, health plan/payer, TPA, PBM, benefits consulting firm, or healthcare analytics organization.
- Knowledge of employer-sponsored health benefits, health plan design, healthcare benchmarking, and/or clinical program evaluation.
- Master’s degree in a related field.
Responsibilities
- Analyze medical, pharmacy, clinical, financial, and eligibility data using SQL and other analytical tools to identify cost drivers, utilization patterns, and emerging trends.
- Develop forecasting models, cost projections, trend analyses, and scenarios to support budgeting and long-term health plan strategy.
- Translate complex healthcare data into actionable recommendations related to plan design, cost management, clinical programs, and employee health outcomes.
- Establish financial, clinical, and utilization metrics and reporting frameworks to monitor health plan performance.
- Evaluate health plan, vendor, and clinical program performance, including financial impact, health outcomes, utilization, member experience, and ROI.
- Conduct benchmarking analyses to identify opportunities to improve plan performance and benefit design.
- Identify opportunities to leverage The Wonderful Company’s on-site health centers and clinical resources to improve health outcomes and reduce avoidable healthcare costs.
- Partner with Benefits leadership and the Chief Medical Officer to evaluate significant clinical, utilization, and cost trends.
- Develop clear, executive-ready presentations that turn complex analysis into key insights and recommendations.
- Lead cross-functional analytical projects by aligning stakeholders, managing timelines, and driving work through completion.
Benefits
- Access to top-notch medical coverage comprehensive vision and dental plans
- 401k with match eligibility
- 24/7 online physician consultations
- virtual mental health resources
- life coaching
- engaging employee community groups
- cash rewards for healthy habits and fitness reimbursements
- library of on-demand fitness videos
- Clear paths for career progression and internal mobility
- Dedicated Learning and Organizational Development department, offering extensive resources like People Manager and leadership training, webinars, and eLearning courses.
- Company-wide mentorship program
- Continuous Improvement Training
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What This Job Offers
Job Type
Full-time
Career Level
Senior
