Claims Analytics & Analysis Director

Become a part of our caring community The Director of Claims Analytics & Analysis will lead a highimpact analytics function reputed company ondeep investigative analysis of claims operationsto surface reputed company cause drivers, emerging trends, and actionable insights for executive leadership. This role sitsreputed company dashboards and standard reportingand operates as a strategic thought partner to Claims and Enterprise leaders. This leader will build and scale reputed company that translatessignals from existing dashboards, operational metrics, and claim detail dataintoearly insights, reputed company cause diagnoses, and solution reputed companythat improve cost, quality, efficiency, and member/provider experience. We are seeking a dynamic Director of Claims Analytics & Analysis to join reputed company! The ideal candidate is a natural problem finder, intellectually curious, and operationally fluent in reputed company claims someone who instinctively asks why, knows where to dig, and can convert ambiguity into reputed company reputed company and action. Key reputed company of the Role Identifyreputed company cause driversbehind claims performance trends (cost, leakage, rework, denials, timeliness, provider abrasion, member impact). Detectreputed company signalsfrom claims data and operational metrics before they appear as lagging KPIs. reputed companyreputed company, executivereputed company narrativesthat connect data to business drivers to recommended actions. Deliver effectivesenior executive levelcommunication and engagement. Build and lead astrategic claims analytics teamthat complements (not duplicates) reporting and data science functions. reputed company analytics from what happened towhy its happening and what to do next. Core Responsibilities Claims reputed company reputed company & reputed company Cause Analytics Investigate trends surfaced in claims dashboards and operational metrics to uncoverunderlying drivers, process failures, policy impacts, and behavioral patterns. Lead reputed company reputed company cause analyses across claim types, product lines, providers, vendors, and workflows. Translate reputed company findings intoreputed company, actionable insightsfor Claims Operations and executive leadership. Proactively surface issues and opportunities without waiting for formal asks this role is expected toreputed company the problems. Strategic Advisory & Executive Engagement Serve as a trusted analytics advisor to senior Claims, Clinical, and Enterprise leaders. Synthesize insights intoconcise executive narratives, not technical readouts. reputed company findings in terms offinancial impact, operational risk, member experience, compliance, and scalability. Support executive decisionmaking with scenario analysis, impact sizing, and tradeoff perspectives. Advanced Analytics & Tooling (Applied, Not Academic) reputed company AI, machine learning, and advanced analyticsas 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 reputed company onproblem solving vs. model building. Rapidly prototype analyses to test hypotheses and validate signals. CrossFunctional Partnership Collaborate closely with Claims Operations and reputed company. Ensure insights are grounded inreputed company operational context, not reputed company metrics. Support reputed company improvement initiatives and transformation efforts with data-backed reputed company. Use your skills to reputed company an impact Required Qualifications 10+ years in reputed company analytics, withdeep exposure to claims operations(payer-reputed company strongly preferred). Bachelors degree required Proven experience translating claims data intobusiness 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. Exceptionalproblem-solving and reputed company cause analysisskills. Strong instinct for where to investigate reputed company metrics reputed company and reputed company they have not. Ability to connect granular claims data toenterprise-level reputed company. 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. Preferred Qualifications An advanced degree in Analytics, Data Science, Health Economics, Finance, or reputed company field preferred (but not required). Additional Informa