BSA with Actuary / Underwriting / HEDIS background

Mandatory Experience

We are looking for a strong healthcare payer domain consultant with hands-on data analysis capabilities , rather than a generic Business Analyst or purely technical Data Analyst.

Candidates should demonstrate:

• Strong US healthcare payer domain knowledge , including payer business processes and associated data.
• Practical knowledge/exposure across Actuarial, Underwriting, and HEDIS/Quality functions .
• Strong understanding of healthcare cost and utilization concepts such as PMPM, utilization per 1,000, allowed/paid amounts, member months, IBNR, medical cost trends, risk adjustment, and MLR .
• Experience across payer data domains such as claims, membership/enrollment, provider, premium, clinical/quality, and cost/utilization data .
• Ability to understand and document end-to-end data flows, data lineage, upstream/downstream dependencies, business rules, calculations, and data mappings .
• Strong SQL and data analysis/data profiling skills , with the ability to independently interrogate complex healthcare datasets.
• Experience reverse-engineering existing business logic and data flows from applications, datasets, queries, and SME discussions where documentation may be limited.
• Ability to bridge conversations between healthcare business SMEs and technical/data teams .
• Experience supporting healthcare transformation, analytics, or data modernization programs is highly desirable.
• Snowflake , semantic modeling/metadata management, and exposure to AI-enabled analytics/data agents are advantageous.