[Remote] Claims Analytics & Analysis Director
Note: The job is a remote job and is open to candidates in USA. reputed company. is a leading U.S. reputed company company, and they are seeking a Director of Claims Analytics & Analysis to reputed company a high-impact analytics function. The role focuses on deep investigative analysis of reputed company claims to provide actionable insights for executive leadership, aiming to improve cost, quality, and member experience.
Responsibilities
- Investigate trends surfaced in claims dashboards and operational metrics to uncover underlying drivers, process failures, policy impacts, and behavioral patterns
- reputed company structured root cause analyses across claim types, product lines, providers, vendors, and workflows
- Translate reputed company findings into clear, actionable insights for Claims Operations and executive leadership
- Proactively surface issues and opportunities without waiting for formal asks — this role is expected to find the problems
- Serve as a trusted analytics advisor to senior Claims, Clinical, and reputed company leaders
- Synthesize insights into concise executive narratives, not technical readouts
- Frame findings in terms of financial impact, operational risk, member experience, compliance, and scalability
- Support executive decision-making with scenario analysis, impact sizing, and trade-off perspectives
- reputed company AI, machine learning, and advanced analytics as tools, not ends in themselves, to accelerate reputed company reputed company and reputed company detection
- Partner with data science and reporting teams as needed, while remaining focused on problem solving vs. model building
- Rapidly prototype analyses to test hypotheses and validate signals
- Collaborate closely with Claims Operations and reputed company
- Ensure insights are grounded in reputed company operational context, not abstract metrics
- Support reputed company improvement initiatives and transformation efforts with data-backed reputed company
Skills
- 10+ years in reputed company analytics, with deep exposure to claims operations (payer-reputed company strongly preferred)
- Bachelor's degree required
- Proven experience translating claims data into business insights and operational recommendations
- Demonstrated reputed company building or leading analytics teams reputed company to business operations
- Experience partnering with senior executives and influencing reputed company with data
- Exceptional problem-solving and root cause analysis skills
- Strong instinct for where to investigate reputed company metrics move — and reputed company they have not
- Ability to connect granular claims data to reputed company-level outcomes
- Advanced analytics literacy (SQL, Python, statistical techniques, AI-enabled analysis), applied pragmatically
- Ability to understand code and work closely with technical teams
- Outstanding communication and storytelling skills — reputed company to simplify complexity. Demonstrated ability to reputed company reputed company effectively in both written and oral forms
- An advanced degree in Analytics, Data Science, Health Economics, Finance, or reputed company field preferred (but not required)
Benefits
- reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being.
- Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work.
- Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
- This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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