Manager - Claims Analytics

Manager, Claims Analytics

AArete is one-of-a-kind when it comes to consulting firm culture.

We’re a global, innovative management and technology consulting firm with offices in the U.S. and India. Our name comes from the Greek word for excellence: “Areté.”  And excellence is exactly what we strive for.  

We’re celebrating our fourth year as one of Forbes’ World’s Best Management Consulting Firms – and our success starts with our people. From robust career development planning to competitive life and wellness benefits, AArete’s “Culture of Care” takes a holistic approach to the employee experience.  

AAretians (our team members) are leaders at every level. You are encouraged to unlock your full potential by directly contributing to our mission and prioritizing personal development and fulfillment. 

The Role

We are seeking a Manager, Claims Analytics to lead analytic workstreams that help health plans better understand their claims data, uncover cost and utilization trends, improve reimbursement accuracy, and enhance overall operational performance. This individual will manage project delivery, mentor team members, and develop analytic solutions that generate meaningful insights for payer and provider clients.

This role requires strong experience working with healthcare claims data, technical and analytical expertise, and the ability to translate complex findings into clear, actionable recommendations for stakeholders.

Work You’ll Do

• Lead day-to-day delivery of claims analysis projects for multiple payer and provider clients
• Design analytic approaches that evaluate utilization, cost drivers, reimbursement patterns, and operational opportunities
• Develop advanced SQL queries, data models, and automated workflows to create scalable analytic solutions
• Guide managers and consultants in working with complex datasets including medical, pharmacy, eligibility, provider, and pricing files
• Validate data accuracy, ensure consistency across multiple data sources, and maintain rigorous quality checks
• Build dashboards and reporting frameworks using BI tools to support client decision making
• Translate large volumes of claims data into clear, compelling insights tailored to executive-level stakeholders
• Manage project plans, timelines, and prioritization across concurrent engagements
• Partner with clients to understand goals, develop custom analyses, and make strategic recommendations
• Support business development through proposals, scoping discussions, and client presentations
• Contribute to internal best practices, methodologies, and analytics frameworks
• Other duties as assigned

Requirements

• 10+ years of experience in claims analytics, healthcare data analytics, actuarial analysis, or payer/provider operations.
• Knowledge of payer operations, provider contracting concepts, and healthcare financial analysis
• Strong communication skills with ability to explain analytic findings clearly, verbally and through Executive decks.
• Understanding of reimbursement methodologies across Medicare, Medicaid, Commercial, and other lines of business
• Working knowledge of healthcare coding and reimbursement structures including CPT, HCPCS, ICD, DRG, APC, and fee schedules
• Demonstrated experience leading project teams or mentoring analysts and consultants
• Strong experience analyzing healthcare claims datasets, including medical and pharmacy
• Proficiency in SQL or similar query languages used to analyze complex datasets
• Ability to identify trends, anomalies, utilization patterns, and cost drivers within claims data
• Experience with BI tools such as Power BI, Tableau, or Qlik
• Advanced proficiency in Excel or equivalent data tools
• Willingness to engage in direct client interaction.

Preferred Requirements

• Experience supporting practice growth, solution development, or analytics capability expansion
• Experience designing automated analytic workflows or ETL processes
• Experience with SQL Server, SSIS, Python, Snowflake, or similar data environments
• Familiarity with data warehousing concepts and healthcare data architecture
• Experience building visual analytics dashboards for ongoing monitoring and reporting

Benefits

• Flexible Paid Time Off of up to 23 days annually, in addition to 10 paid public holidays
• Hybrid work model with flexible in-office attendance
• Comprehensive health benefits including medical insurance (Mediclaim), personal accident insurance, and term life insurance
• Generous paid parental leave program
• Attractive employee referral bonus scheme
• Transportation allowance and night shift allowance
• Employee advance salary loan facility
• Structured professional certification reimbursement policy to support ongoing learning and development

We put humans at the center of our work 

But what sets us apart is our people. We are guided by our deeply embedded guiding principles: Excellence, Passion, Loyalty to Clients, Stewardship, Family, Community, Sustainability, and Inclusion.  

And we’ve been recognized as a top firm to work for by companies like Forbes, Top Workplaces Chicago Tribune, and Consulting Magazine.  

We’ve earned a Great Place to Work Certification™ and been named a World’s Best Management Consulting Firm by Forbes, Vault’s Top 50 Firms to Work For, Crain's Chicago Business Fast 50, Inc 5000’s Fastest Growing Firms, and Consulting Magazine's Fastest Growing Firms.  

Learn more about our award-winning culture 

We are an Equal Employment Opportunity Employer 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. 

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