Healthcare Analytics Consultant

Job Summary

A company is looking for a Senior Manager/ Associate Director - Analytics Consulting (Healthcare Claims).

Key Responsibilities

• Gather requirements by analyzing client pain points in Medicare and Medicaid processes, focusing on claims management
• Evaluate and recommend AI and analytics use cases to address client challenges related to complex business logics
• Provide insights and guidance on solution design, ensuring alignment with Medicare and Medicaid complexities

Required Qualifications

• 12-15 years of deep domain consulting experience
• Extensive understanding of US healthcare, Medicare, and Medicaid regulations
• Good understanding of plan offerings and eligibility for Medicare and Medicaid programs
• Knowledge of CMS guidelines, ACA, and HIPAA regulations
• Masters/Bachelor of Science/Engineering or MBA preferred; healthcare certifications are a plus