Senior Consultant, Claims Analytics Specialist

Senior Consultant, Claims Analytics Specialist Welcome to AArete, a unique consulting firm that values excellence and innovation. We pride ourselves on our dynamic culture that fosters personal and professional growth for every team member. As a globally recognized management and technology consulting firm, with offices in the U.S., India, and Europe, we are excited to continue our legacy as one of Forbes' World's Best Management Consulting Firms. Our success stems from our commitment to our people, who thrive in our 'Culture of Care' that emphasizes career development and well-being. The Role Are you ready to take your career to the next level? We are looking for a Senior Consultant, Claims Analytics to spearhead advanced analytic projects that aid health plans in understanding and optimizing claims data. You'll play a pivotal role in our analytics pod, especially within the medical management and prior authorization workstream. This is a prime opportunity to showcase your analytical expertise by leading complex analyses, mentoring junior team members, and delivering actionable insights for our clients. What You'll Do Lead the execution of claims analytics projects catering to payer and provider clients. Design innovative analytical strategies to assess utilization, cost drivers, reimbursement patterns, and operational improvements. Develop advanced SQL queries, data models, and scalable analytic workflows. Analyze intricate datasets including medical, pharmacy, eligibility, provider, and pricing data. Ensure data accuracy and consistency across multiple sources. Create impactful dashboards and reporting frameworks using BI tools to bolster client decision-making. Effectively translate complex claims data into concise insights and recommendations for stakeholders. Collaborate closely with clients to comprehend their objectives and deliver tailored analyses. Guide and nurture junior consultants and analysts. Support project planning, prioritization, and successful delivery across multiple engagements. Contribute to the evolution of internal analytics methodologies and best practices. Assist in business development through proposals, scoping discussions, and client presentations. Perform additional duties as required. Requirements 6 to 9+ years of experience in claims analytics, healthcare data analytics, or payer/provider operations, complemented by a Bachelor's degree or equivalent experience. Proficient understanding of healthcare claims data, including medical and pharmacy datasets. Strong command of SQL and experience working with large, complex datasets. Familiarity with Snowflake, Python, Excel, and Power BI. In-depth knowledge of reimbursement methodologies across Medicare, Medicaid, and Commercial lines of business. Adept at identifying trends, anomalies, utilization patterns, and cost drivers in claims data. Working knowledge of healthcare coding and reimbursement structures including CPT, HCPCS, ICD, DRG, APC, and fee schedules. Experience with BI tools such as Power BI, Tableau, or similar platforms. Exceptional communication skills with the ability to convey technical findings as business insights. Proven ability to operate independently and manage complex analytical projects. Experience in mentoring or supporting junior colleagues. Must be legally authorized to work in the United States without employer sponsorship. Preferred Requirements Experience in medical management, utilization management, prior authorization, or clinical operations analytics. Background working with health plans or consulting firms. Experience creating automated analytic workflows or ETL processes. Knowledge of SQL Server, SSIS, Python, Snowflake, or similar data environments. Familiarity with healthcare data architecture and data warehousing concepts. Experience building visual analytics dashboards for ongoing monitoring and reporting. Based in Chicago, IL, with the flexibility to work from the Chicago office as needed. Compensation & Benefits Flexible PTO, monthly half-day refuels, volunteer time off, and 10 paid holidays. Own Your Day flexible work policy. Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match. Generous paid parental leave options. Employer-paid Life Insurance, Short Term Disability, Long Term Disability. Charitable contribution matching program. New client commission opportunities and referral bonus program. Bike share discount program. The estimated base salary range for this position is $125,000 - $145,000, alongside potential eligibility for an annual discretionary bonus. This range is part of a comprehensive compensation package including majority employer-paid benefits and incentive pay for eligible roles. Please note that individual total compensation may vary based on factors like experience level, certifications, and other relevant considerations. At AArete, we are committed to putting people at the center of our work and driving purposeful change through our expertise. Join us and be part of a firm recognized for its outstanding culture and employee satisfaction. We are an Equal Employment Opportunity Employer and encourage all qualified candidates to apply regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. #LI-DNI

Created: 2026-03-08