Claims Data Strategy Lead

Job Summary

Driving end-to-end healthcare claims data initiatives, the full-time Claims Data Strategy Lead will provide senior-level leadership and technical expertise to identify problems, implement solutions, and deliver outcomes in a remote work environment.

Key Responsibilities:

• Own and drive solutions across healthcare claims data initiatives from problem definition through implementation and validation
• Serve as a senior authority on various claims data types, including medical, pharmacy, and behavioral health
• Design and optimize advanced SQL-based data models and automation frameworks focused on performance and scalability

Required Qualifications:

• Bachelor's degree in Computer Science, Information Systems, or a related field, or equivalent practical experience
• 7-10 years of experience with healthcare data, specializing in claims data and analytics
• Expert-level proficiency in SQL and advanced query development across large datasets
• Extensive experience in building and optimizing complex data models and automation frameworks within SQL platforms
• Strong understanding of healthcare claims data structures and the ability to develop complex claim adjustment logic