Sr. Analyst, Health Plan Analytics

The Sr. Analyst, Health Plan Analytics operates at the intersection of FP&A, analytics, and population health, turning claims and clinical data into the insight that drives Hopscotch’s value-based care performance. Working on top of our engineering-governed data foundation, this role involves maturing and maintaining the standard claims model and the reporting infrastructure that underpins financial close, clinical review, and performance management.

We're looking for someone who is technically excellent, with the judgment to know when a number is wrong and why.

Key Responsibilities

• Support the in-house build of Hopscotch’s cost categorization capability – including customizations, updates for new code and mappings, and change management.
• Own the ongoing maintenance, enhancements, governance, change control, and documentation for Hopscotch’s payer data and cost categorization capabilities.
• Build and maintain the medical economics reporting suite (SQL, Power BI, Excel) and support IBNR estimation, cohort forecasting, and paid-risk pacing.
• Review monthly outputs to surface cost drivers and emerging trends, distinguishing real movement from the impact of incomplete claims and statistical noise.
• Analyze medical cost trends across factors such as unit cost, utilization, mix; and enrich claims with EHR, eligibility, provider, and risk adjustment data to explain population-level trends and financial performance.
• Work with medical economics and finance leadership to identify and complete high-impact analyses, including pro forma and ROI for medical cost initiatives.
• Partner across Clinical, Operations, and Finance to translate business questions into analyses, ensure results flow accurately into management reporting, and build repeatable analytic processes that scale across programs.

About You

• You build and interrogate – you can stand up a clean dataset and tell when the output doesn’t pass the smell test or is logically inconsistent.
• You exercise critical thinking and understand the conceptual framework and database relationships underlying healthcare data.
• You are comfortable with ambiguous problems and immature data and take pride in acknowledging what’s unknown while taking steps to fill the gaps.
• You form a point of view; you don’t just produce the number, you explain what’s driving it and why it matters.
• You document as you build, so your definitions are transparent and others can rely on them.
• You’re a self-starter with an ownership mindset, thrive in a fast-paced environment, and care about transforming rural healthcare.

Qualifications

• A Bachelor’s degree in Economics, Finance, Statistics, Mathematics, Health Informatics, Actuarial Science, or a related quantitative field.
• 3+ years of experience in healthcare analytics or medical economics (payer, provider, health system, ACO, or VBC).
• High proficiency in SQL, Power BI, and Excel.
• Hands-on experience with healthcare claims data, and combining data sources (claims, eligibility, EHR, risk adjustment).
• Familiarity with healthcare financial and utilization concepts (e.g., PMPM, MLR, utilization per 1,000, trend, risk adjustment).
• Experience with maturing data models, identifying improvement opportunities while still generating value from nascent datasets.
• Experience presenting and communicating data-driven insights to functional leaders.

Preferred / Bonus Qualifications

• Direct value-based care / medical-economics analytics experience, and familiarity with key considerations and leading methodologies for claims cost categorization.
• Experience with Palantir Foundry or a comparable enterprise data platform.
• Comfort using AI-assisted tooling to accelerate build and analysis.
• Statistical methods (regression, difference-in-differences, propensity score matching).
• Experience leading technical/analytical projects with combined teams of functional and technical stakeholders.