Homeoffice Sr. Director, Analytics Advisory(remote) en Claritev
Claritev · Work From Home, Estados Unidos De América · Remote
- Senior
At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!
JOB SUMMARY: The Sr. Director -- Analytics advisory acts as a hands-on leader to build and scale the consulting arm that transforms complex healthcare-claims and benefits data into executive-ready insights and strategic recommendations for our clients. This role will own the full advisory lifecycle -- from solution design and methodological rigor to project delivery client relationship management, and P&L performance -- while partnering with Product, IT and Sales to turn analytic innovation into measurable growth.
JOB ROLES AND RESPONSIBILITIES:
1. Leads client-facing analytics and actuarial engagements end-to-end, translating complex quantitative outputs into clear, actionable recommendations that improve healthcare affordability and transparency for our clients.
2. Develop and govern actuarial and statistical methods -- predictive modeling, cost trend analysis, network discount studies, repricing simulations) to ensure methodological and regulatory compliance.
3. Deliver price-transparency based repricings by combining historical claims data with published payor and provider rates, quantifying savings opportunities and disruption scenarios.
4. Develop, refine and scale the methodologies needed to evaluate various point solution and their overall impact on healthcare costs.
5. Partners with Product and IT leaders to identify data assets and platform features that amplify advisory value and create new revenue-generating solutions.
6. Establish SLAs, quality control checkpoints, and customer-satisfaction metrics, driving continuous improvements across all advisory deliverables.
7. Own P&L performance for advisory portfolio; forecast, budget and optimize project margins while expanding existing accounts.
8. Recruit, mentor, and performance manager a high-performing team of actuaries and healthcare consultants, fostering a culture of evidence-based decision making.
9. Collaborate, coordinate, and communicate across disciplines and departments.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
2. Develop and govern actuarial and statistical methods -- predictive modeling, cost trend analysis, network discount studies, repricing simulations) to ensure methodological and regulatory compliance.
3. Deliver price-transparency based repricings by combining historical claims data with published payor and provider rates, quantifying savings opportunities and disruption scenarios.
4. Develop, refine and scale the methodologies needed to evaluate various point solution and their overall impact on healthcare costs.
5. Partners with Product and IT leaders to identify data assets and platform features that amplify advisory value and create new revenue-generating solutions.
6. Establish SLAs, quality control checkpoints, and customer-satisfaction metrics, driving continuous improvements across all advisory deliverables.
7. Own P&L performance for advisory portfolio; forecast, budget and optimize project margins while expanding existing accounts.
8. Recruit, mentor, and performance manager a high-performing team of actuaries and healthcare consultants, fostering a culture of evidence-based decision making.
9. Collaborate, coordinate, and communicate across disciplines and departments.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
The incumbent will serve as both a strategist and a hands-on practitioner. This role involves transforming extensive claims and price transparency data into actuarially sound insights aimed at enhancing healthcare affordability and transparency. Additionally, the incumbent will design and oversee advanced analytic and actuarial engagements, claims analyses, and price transparency-based repricing methodologies to deliver clear, actionable recommendations to our clients. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.)
The incumbent will serve as both a strategist and a hands-on practitioner. This role involves transforming extensive claims and price transparency data into actuarially sound insights aimed at enhancing healthcare affordability and transparency. Additionally, the incumbent will design and oversee advanced analytic and actuarial engagements, claims analyses, and price transparency-based repricing methodologies to deliver clear, actionable recommendations to our clients. This is a people management job with authority for all HR actions (hiring, firing, discipline, training, etc.)
