Location: Hybrid (Local to NYC, Denver, or Charlotte)

Position Summary:

The Principal Analyst serves as a senior individual contributor responsible for translating complex medical and pharmacy data into actionable business insights that drive strategic decision-making. This role partners closely with Finance, Actuarial, Clinical, Product, Client-facing, and operational teams to evaluate healthcare cost drivers, utilization trends, financial performance, and opportunities to improve affordability and outcomes. The ideal candidate combines deep healthcare domain expertise with advanced analytical capabilities and experience supporting actuarial, healthcare economics, underwriting, risk management, value-based care, or strategic healthcare consulting initiatives. This individual is expected to move beyond reporting and serve as a trusted advisor who identifies risks, opportunities, and emerging trends across medical and pharmacy benefits.

Why you’ll love working here:

• Help build and scale a high-impact healthcare economics and analytics capability within a growing healthcare technology organization.
• Work on complex, business-critical questions that influence healthcare cost management, financial performance, underwriting, network strategy, client value, and affordability.
• Partner with senior stakeholders while contributing to strategic analytics, executive-ready recommendations, reusable analytical assets, reporting standards, and scalable processes.

Position Responsibilities:

• Healthcare Economics & Strategic Analytics
  • Analyze medical and pharmacy claims, eligibility, provider, utilization, cost, and financial data to identify trends, cost drivers, utilization patterns, and opportunities for intervention.
  • Evaluate the financial impact of benefit design, formulary strategies, clinical programs, network arrangements, utilization management initiatives, and other healthcare cost management strategies.
  • Develop actionable insights that support affordability, healthcare cost management, clinical effectiveness, client value, and measurable business outcomes.
  • Perform healthcare economic analyses, forecasting, benchmarking, and modeling to support strategic planning, financial performance measurement, and business decision-making.
• Actuarial & Financial Partnership
  • Partner with actuarial, finance, underwriting, healthcare economics, and financial performance stakeholders to support pricing, forecasting, reserving, trend analysis, and risk assessment activities.
  • Contribute analytical expertise to budget planning, financial projections, business cases, ROI evaluations, and strategic healthcare cost initiatives.
  • Support the development and validation of key healthcare cost, utilization, trend, and financial performance metrics used in operational and strategic planning.
  • Translate actuarial, underwriting, healthcare economics, and business needs into clear analytical approaches, defensible assumptions, and decision-ready recommendations.
• Client & Business Consultation
  • Serve as a consultative partner to business leaders, translating complex analytical findings into strategic recommendations and practical next steps.
  • Present insights and recommendations to executive leadership, operational stakeholders, and client-facing teams with clarity, confidence, and appropriate context.
  • Collaborate across departments to identify opportunities for performance improvement, healthcare cost reduction, affordability, and measurable business impact.
  • Clarify business problems, success criteria, assumptions, trade-offs, and delivery options before significant analytical work begins.
• Advanced Analytics & Scalable Execution
  • Leverage large, complex healthcare datasets to conduct ad hoc investigations, root cause analyses, predictive analyses, descriptive analyses, and trend evaluations.
  • Develop analyses that support value-based care, population health, cost containment, network strategy, clinical program evaluation, and growth initiatives.
  • Design scalable analytical approaches, reusable assets, quality controls, and repeatable frameworks that improve organizational understanding of healthcare costs, utilization, quality, and outcomes.
  • Work independently in SQL, Python, R, SAS, Tableau, Excel, or similar tools to extract, transform, analyze, visualize, and communicate complex healthcare data.

Minimum Qualifications:

• 5+ years of experience in healthcare analytics, healthcare economics, actuarial support, financial analytics, underwriting analytics, benefits consulting, provider/network analytics, or strategic healthcare consulting.
• Demonstrated experience analyzing both medical and pharmacy claims data, including eligibility, provider, utilization, cost, trend, and financial performance data.
• Demonstrated experience partnering with actuarial, underwriting, healthcare economics, or financial performance teams to support healthcare cost analysis, forecasting, trend evaluation, pricing, risk assessment, or strategic decision-making.
• Strong understanding of healthcare cost and utilization drivers, trend analysis, forecasting, benchmarking, financial performance measurement, risk adjustment concepts, and claims-based analytical methods.
• Experience developing executive-level recommendations, business cases, ROI evaluations, and strategic narratives based on complex analytical findings.
• Strong SQL skills and experience using Python, R, SAS, Tableau, Excel, Power BI, or similar tools for healthcare data analysis, automation, statistical modeling, visualization, or reporting.
• Ability to translate ambiguous stakeholder needs into structured analytical approaches, defensible assumptions, clear deliverables, and actionable recommendations.
• Experience working in environments such as health plans, PBMs, healthcare consultancies, employer health benefits organizations, actuarial organizations, managed care organizations, TPAs, or integrated delivery systems.

Preferred Qualifications:

• Background in healthcare economics, medical and pharmacy analytics, actuarial consulting, financial analytics consulting, benefits consulting, value-based care analytics, provider analytics, network analytics, underwriting, or risk adjustment.
• Experience with forecasting, trend evaluation, healthcare cost modeling, benchmarking, pricing, renewal strategy, repricing, disruption analysis, self-funded employer group analysis, episode groupers, risk adjustment models, utilization benchmarks, or provider/network performance analytics.
• Experience supporting actuarial, healthcare economics, benefits consulting, health plan, PBM, managed care, employer health benefits, or value-based care organizations.