Analyze healthcare claims data to support negotiations and reimbursement strategies, develop financial models, and ensure data accuracy in claims analysis.
We are seeking an experienced Senior Data Analyst with a strong background in healthcare claims, payer analytics, and reimbursement models. You will play a key part in analyzing medical and pharmacy claims data to support contract negotiations, provider reimbursement strategies, and sales initiatives. You will have a deep understanding of payer systems, Medicare reimbursement structures, fee schedules, and healthcare financial models.
How you will make an impact
- Analyze medical and pharmacy claims data to identify trends, cost drivers, and opportunities for optimization.
- Support provider contracting and payer negotiations by evaluating reimbursement models, pricing structures, and fee schedules.
- Develop financial models to assess payer performance, reimbursement strategies, and cost containment opportunities.
- Collaborate with sales and contracting teams to provide data-driven insights that support growth initiatives.
- Work with Medicare, Medicaid, and commercial claims data to track reimbursement trends and regulatory changes.
- Build reports and dashboards using SQL, Python, Power BI, or Tableau to visualize key business metrics.
- Evaluate the financial impact of alternative payment models, value-based care initiatives, and provider incentives.
- Ensure data integrity and accuracy in claims analysis to support strategic decision-making.
- Partner with internal teams to streamline claims processing, payment accuracy, and operational efficiencies.
What we are looking for
- Bachelor’s or Master’s degree in Healthcare Analytics, Statistics, Finance, Data Science, or a related field.
- 3+ years of experience in healthcare claims analysis, payer analytics, or reimbursement modeling.
- Strong knowledge of Medicare and commercial payer reimbursement methodologies.
- Experience with medical and pharmacy claims data, provider fee schedules, and healthcare financial modeling.
- Proficiency in SQL, Python, R for data analysis.
- Familiarity with contract negotiations, network management, and provider relations is a plus.
- Excellent communication skills to present data-driven insights to stakeholders.
Top Skills
Power BI
Python
R
SQL
Tableau
Similar Jobs
AdTech • Big Data • Machine Learning • Marketing Tech • Mobile • Software
The Senior Data Analyst will lead high-impact projects, analyze data to drive business recommendations, automate reporting, and mentor teams across various stakeholders.
Top Skills:
LookerPythonSQLTableau
Blockchain • Internet of Things • Payments • Cryptocurrency • Web3
As a Senior Data Analyst at Chainlink Labs, you will analyze economic models, design systems, and influence data-driven decisions for blockchain economic projects.
Top Skills:
GoPythonRustSoliditySQL
AdTech • Digital Media • Marketing Tech
The Sr. Data Analyst will collect and analyze data, develop models to identify trends, create dashboards, and present findings to support decision-making in the Knowledge Management and Training team.
Top Skills:
ConfluenceDoceboExcelGoogle AnalyticsJIRALookerMS OfficeSmartsheetTableauZendesk
What you need to know about the Austin Tech Scene
Austin has a diverse and thriving tech ecosystem thanks to home-grown companies like Dell and major campuses for IBM, AMD and Apple. The state’s flagship university, the University of Texas at Austin, is known for its engineering school, and the city is known for its annual South by Southwest tech and media conference. Austin’s tech scene spans many verticals, but it’s particularly known for hardware, including semiconductors, as well as AI, biotechnology and cloud computing. And its food and music scene, low taxes and favorable climate has made the city a destination for tech workers from across the country.
Key Facts About Austin Tech
- Number of Tech Workers: 180,500; 13.7% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Dell, IBM, AMD, Apple, Alphabet
- Key Industries: Artificial intelligence, hardware, cloud computing, software, healthtech
- Funding Landscape: $4.5 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Live Oak Ventures, Austin Ventures, Hinge Capital, Gigafund, KdT Ventures, Next Coast Ventures, Silverton Partners
- Research Centers and Universities: University of Texas, Southwestern University, Texas State University, Center for Complex Quantum Systems, Oden Institute for Computational Engineering and Sciences, Texas Advanced Computing Center
