Note: The job is a remote job and is open to candidates in USA. Hopscotch Primary Care is a healthcare organization focused on improving access to high-quality primary care in rural communities through a value-based care model. The Sr. Analyst, Health Plan Analytics will turn claims and clinical data into insights supporting financial close, clinical review, performance management, medical economics reporting, forecasting, and value-based care initiatives.
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 (e.g., SQL, PBI, 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 trend 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
Skills
- • Bachelor's 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
- • You build and you 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 that underly 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
- • 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
Benefits
- Paid holidays + PTO
- Company sponsored medical, dental, and vision insurance for you + your family
- FREE short-term and long-term disability insurance
- FREE $100k life insurance policy
- 401k plan with 4% company match + no vesting period
- $720 - $1,000 added to employee Health Savings Account annually for eligible health plans
Company Overview