Senior Consultant, Claims Analytics

Senior Consultant, Claims Analytics

AArete is one-of-a-kind when it comes to consulting firm culture.

We’re a global, innovative management and technology consulting firm with offices in the U.S., India, and Europe. Our name comes from the Greek word for excellence: “Areté.”  And excellence is exactly what we strive for.  

We’re celebrating our fourth year as one of Forbes’ World’s Best Management Consulting Firms – and our success starts with our people. From robust career development planning to competitive life and wellness benefits, AArete’s “Culture of Care” takes a holistic approach to the employee experience.  

AAretians (our team members) are leaders at every level. You are encouraged to unlock your full potential by directly contributing to our mission and prioritizing personal development and fulfillment. 

The Role

We are seeking a Senior Consultant, Claims Analytics to support and lead advanced analytic engagements that help health plans better understand claims data, uncover cost and utilization trends, improve reimbursement accuracy, and enhance operational performance.

This role will play a key leadership role within the analytics pod, particularly within the medical management and prior authorization workstream. The Senior Consultant will operate with minimal ramp-up time, drive complex analyses, mentor junior team members, and translate data into actionable insights for clients.

Work You’ll Do

• Lead day-to-day execution of claims analytics projects across payer and provider clients
• Design analytic approaches to evaluate utilization, cost drivers, reimbursement patterns, and operational opportunities
• Develop advanced SQL queries, data models, and scalable analytic workflows
• Analyze complex datasets including medical, pharmacy, eligibility, provider, and pricing data
• Validate data accuracy and ensure consistency across multiple data sources
• Build dashboards and reporting frameworks using BI tools to support client decision making
• Translate complex claims data into clear insights and recommendations for stakeholders
• Partner with clients to understand objectives and develop custom analyses
• Mentor and train junior consultants and analysts
• Support project planning, prioritization, and delivery across concurrent engagements
• Contribute to internal analytics methodologies, best practices, and frameworks
• Support business development through proposals, scoping discussions, and client presentations
• Other duties as assigned

Requirements

• 6 to 9+ years of experience in claims analytics, healthcare data analytics, or payer/provider operations with a Bachelor’s degree, or equivalent experience
• Strong experience working with healthcare claims data, including medical and pharmacy datasets
• Proficiency in SQL and experience analyzing large, complex datasets
• Experience with Snowflake, Python, Excel, and Power BI
• Strong understanding of reimbursement methodologies across Medicare, Medicaid, and Commercial lines of business
• Ability to identify 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
• Strong communication skills with ability to translate technical findings into business insights
• Ability to operate independently and manage complex analytical workstreams
• Experience mentoring or supporting junior team members
• Must be legally authorized to work in the United States without employer sponsorship

Preferred Requirements

• Experience in medical management, utili