Director Business Analytics

Key Responsibilities 

• Lead analytics initiatives supporting total cost of care performance across specialty services 

• Identify drivers of specialty spend across specialties such as vision, dermatology, therapy etc.,  

• Monitor PMPM trend performance across specialties and all lines of business. 

• Evaluate utilization patterns and recommend cost-reduction opportunities 

• Design analytics frameworks measuring provider efficiency, access, and quality performance 

• Evaluate book-of-business claims experience to develop insights on profitability and competitive positioning across products and markets 

• Support underwriting and growth teams with data analysis and insights for new client proposals and value propositions 

• Analyze site-of-care optimization opportunities, network leakage and utilization across provider networks 

• Support contract performance evaluation and savings analysis 

• Partner with finance, clinical and operational leadership to define and develop KPIs aligned with enterprise performance goals. 

• Present insights and recommendations to leadership in a clear, concise, and data-driven manner   

• Lead cross-functional collaboration with IT, data engineering, operations, and quality teams to improve data architecture and reporting accessibility. 

• Mentor junior analysts and strengthen analytics capabilities across teams. 

• Drive automation of manual reporting workflows and implementation of scalable reporting solutions. 

• Establish documentation standards, reporting governance processes, and analytics best practices. 

• Support integration of AI tools into technical operations 

• Perform other duties as needed 

Required Qualifications 

• Bachelor’s degree (or equivalent experience) in public health, data analytics, health informatics, business, or a related field. 
• 8+ years of experience with advanced proficiency in SQL, Excel, and Power BI/Tableau in healthcare analytics environments 
• 5+ years of experience working with healthcare datasets, including claims, utilization management/prior authorization, care management, and quality measures. 
• Demonstrated leadership managing analytics teams 
• Strong understanding of clinical workflows, utilization and network management analytics, and healthcare economics. 
• Demonstrated ability to translate complex analytics into executive-level insights and operational recommendations. 
• Experience developing presentation materials that articulate insights clearly and persuasively 
• Displays willingness and ability to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions 
• Strong analytical mindset with intellectual curiosity and a passion for problem-solving. 
• Superior attention to detail and strong organizational skills, with the ability to operate effectively in a fast paced, high demand environment while managing multiple priorities 
• Exceptional verbal and written communication skills, with a bias toward clarity, brevity, and decisive communication 

Preferred Qualifications 

• Experience with data science tools and programming languages such as Python or R. 
• Experience incorporating AI into analytics workflows