Analytics Manager ( Healthcare insurance claims )

Experience: 7 Years to 17 yearsPosition SummaryThe International Health Medical Economics team is looking for a Medical EconomicsAnalytics Manager to help identify the drivers of medical cost and utilization trends andtranslate them into actions that improve affordability and health outcomes. This rolecombines healthcare claims expertise, advanced analytics, data visualization, andstakeholder leadership. The successful candidate will lead a team responsible for analysingcomplex claims and eligibility data, identifying actionable opportunities, and partnering withNetwork, Clinical, and Fraud, Waste and Abuse teams to develop targeted interventions.The role is suited to an analytics leader who can move from data exploration and root-causeanalysis to executive communication, recommended interventions, and measurablebusiness action. ResponsibilitiesClaims analytics and insight generation Lead analysis of medical cost and utilization trends to identify underlying driversacross markets, clients, providers, populations, and clinical categories. Apply healthcare claims knowledge to distinguish the effects of utilization, unit cost,provider mix, service mix, disease burden, benefit design, and member behaviour. Develop analytics covering provider performance, population risk, claims leakage,clinical variation, and potential fraud, waste and abuse. Convert analytical findings into clearly defined opportunities, supported by evidence,expected impact, and recommended next actions.Business action and stakeholder partnership Partner with Network teams to support provider benchmarking, contractingstrategies, and provider negotiations. Partner with Clinical teams to identify opportunities related to care pathways, diseasemanagement, utilization management, and site-of-care optimization. Partner with FWA teams to identify abnormal billing, utilization, and providerbehaviour patterns requiring further investigation. Present complex analytical findings to senior stakeholders in a concise, decision-oriented format. Track whether implemented actions deliver the expected impact and use the resultsto improve future analyses.Analytics products and dashboards Define and develop self-service dashboards that enable users to identify andinvestigate medical cost and utilization drivers more quickly. Translate business questions into analytical requirements, measures, drill-downpathways, and intuitive dashboard designs. Work with Data and Technology teams to ensure analytics products are scalable,reliable, and supported by appropriate data controls.Team and capability leadership Lead, coach, and develop a team of analysts and data specialists. Set analytical priorities based on business value, feasibility, and stakeholder needs. Review analytical approaches and outputs to ensure accuracy, consistency, andactionability. Collaborate with actuarial, finance, data, and analytics teams to reuse existingcapabilities and avoid duplication.Qualifications 10+ years of experience in health insurance claims analytics, medical economics,actuarial analytics, or health insurance consulting, including experience leadinganalytical projects or teams Strong understanding of healthcare claims data, including diagnosis, procedure,provider, place-of-service, utilization, unit-cost, and member-level information Experience using a visualization platform such as Qlik Sense, Power BI, or Tableau Hands-on proficiency in SQL and experience working with large, complex claimsdatasets Strong written, verbal, presentation, and stakeholder-management skills