Payer Analytics Consultant / United States

Abacus Insights; Northern (KY); On-site; USD 120,000 - 180,000; Full time

Benefits offered by this job

Unlimited PTO

Remote-friendly

Health coverage

Equity

Growth opportunities

Home office stipend

Phone allowance

Job summary

Abacus Insights is a data and AI platform pioneer transforming health plans by delivering clean, connected data for faster, more confident decisions. We seek a Payer Analytics Consultant to partner with client teams on payment integrity, provider performance, and payer operations, turning questions into data models, dashboards, and analyses with AI support.

You will travel onsite with the team, gather requirements, present analyses to client stakeholders, and help shape new offerings in payor

Qualifications

• 7–10+ years of hands‑on healthcare data analytics experience with payer, TPA, health plan vendor, or consulting firm serving them.
• Proven ability to build production‑grade dashboards and reporting tools in SQL and BI platforms.
• Strong client‑facing communication and presentation skills.
• Ability to translate ambiguous business questions into structured data models and analyses.
• Experience with AI‑powered tools to accelerate analysis and automate reporting.
• Willingness to travel onsite to client locations as part of a consulting team.

Responsibilities

• Translate client questions into data models, reports, and analyses to support recommendations.
• Travel onsite to client locations to gather requirements and present findings.
• Present data findings, dashboards, and analyses directly to client stakeholders in real time.
• Design and manage data pipelines inside client Snowflake or Databricks environments.
• Perform deep‑dive analyses (utilization trends, cost drivers, quality metrics) and package outputs for clients.
• Leverage AI and automation to accelerate analysis and surface insights faster.
• Ensure data accuracy, consistency, and technical rigor across client deliverables.
• Collaborate with Product, Engineering, and Data teams to scale analytics workflows.
• Maintain knowledge of payer concepts (claims, utilization, quality measures, provider contracting).

Skills

SQL

Power BI

Tableau

Healthcare analytics

Client-facing

AI tools

Travel readiness

Education

Master’s degree

Tools

Snowflake

Databricks

Redshift

BigQuery

Job description

Abacus Insights is transforming how data and AI work for health plans. Our mission is simple: make healthcare data usable, so the people responsible for care and cost decisions can act faster, with confidence.

As the AI and Data Platform for Payer Intelligence, we help health plans break down data silos to create a single, trusted data foundation. That foundation powers better decisions—so plans can improve outcomes, reduce waste, and deliver better experiences for members and providers alike. Backed by $100M from top investors, we're tackling big challenges in an industry that’s ready for change. Our platform enables GenAI use cases by delivering clean, connected, and reliable healthcare data to support automation, prioritization, and decision workflows—and it's why we are leading the way.

Our innovation begins with people. We are bold, curious, and collaborative—because the best ideas come from working together. We embrace the thoughtful use of AI and automation to drive innovation and efficiency, and we look for individuals who are curious and adaptable—those excited to leverage emerging technologies to enhance how we work—while keeping human insight, connection, and our clients at the center of every decision.

Ready to make an impact? Join us and let's build the future together.

About the Role

Abacus Insights is seeking a Payer Analytics Consultant to serve as the dedicated data and analytics partner working side‑by‑side with our business teams and client teams as we launch new and expanded service offerings for health plans. This is a client‑facing subject matter expert role focused on payment integrity, provider performance, and payer operations — turning client questions into the data models, dashboards, and analyses that power their recommendations, leveraging AI and automation wherever it helps you move faster and dig deeper.

In this role, you will travel onsite to client locations alongside other members of the team, gathering requirements in person, presenting your own analysis to client stakeholders, and building the kind of trusted relationships that come from being in the room. This is an individual‑contributor, analytics‑first role: you are both the technical engine that makes our insights possible, accurate, and repeatable, and a visible, credible voice in front of clients yourself. You’ll help set the standard for how Abacus delivers analytics to health plans as these new offerings take off. This role sits at the intersection of payer domain knowledge, hands‑on data analytics, and client delivery.

Your day to day

• Partner closely with Abacus’ Payment Integrity and Payer Business Domain consultants, translating their client questions into data models, reports, and analyses that support their recommendations
• Travel onsite to client locations alongside the consulting team to gather requirements, support live engagements, and build direct relationships with client stakeholders
• Present data findings, dashboards, and analyses directly to client stakeholders — translating technical analysis into clear, actionable takeaways in real time
• Design and manage the queries and data pipelines — working directly inside each client’s own Snowflake or Databricks environment — that pull from client claims, pharmacy, and provider performance systems to support active consulting engagements
• Perform deep‑Dive analyses — utilization trends, cost drivers, quality metrics, provider performance — and package findings into clear, presentation‑ready outputs for consultants and clients alike
• Leverage AI and automation — from AI-assisted query generation to GenAI‑powered insight summarization — to accelerate analysis, reduce manual reporting work, and surface findings faster for consultants and clients
• Ensure data accuracy, consistency, and technical rigor across all client‑facing analytics deliverables
• Partner with Product, Engineering, and Data teams to scale, automate, and productize the analytics workflows and tools the consulting team relies on
• Maintain working knowledge of payer domain concepts — claims, utilization management, quality measures, payment integrity, and provider contracting — so analytics outputs are accurate and meaningfully interpreted

What you bring to the team

• 7–10+ years of hands‑on experience in healthcare data analytics — gained at a payer, TPA, health plan vendor, or consulting firm serving them
• Deep proficiency in SQL and Power BI and/or Tableau, with a track record of building production‑grade dashboards and reporting tools
• Experience analyzing medical/pharmacy claims, provider performance, or payment integrity data
• Comfort translating ambiguous business questions into structured data models and clear analyses
• Strong client‑facing communication and presentation skills — comfortable presenting analysis directly to client stakeholders and fielding questions in real time, not just supporting consultants behind the scenes
• Comfort using AI‑powered tools (e.g., Copilot‑style assistants, GenAI for code/query generation, AI‑enabled BI features) to work faster and surface insights more efficiently
• Willingness and ability to travel onsite to client locations as part of a consulting engagement team
• Working familiarity with payer domain concepts: claims processing, utilization management, quality measures (HEDIS/STAR), payment integrity, or provider contracting

What we’d like to see, but not required

• Experience with Python or another scripting language for data manipulation and automation
• Exposure to payment integrity specifically — claims auditing, fraud/waste/abuse detection
• Exposure to provider performance or network analytics
• Experience with cloud data warehouses (e.g., Snowflake, Databricks, Redshift, BigQuery)
• Master’s degree in a quantitative field, Public Health, or a related discipline

Compensation

Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.

What you’ll get in return

• Unlimited paid time off – recharge when you need it
• Work from anywhere – flexibility to fit your life
• Comprehensive health coverage – multiple plan options to choose from
• Equity for every employee – share in our success
• Growth‑focused environment – your development matters here
• Home office setup allowance – one‑time support to get you started
• Monthly cell phone allowance – stay connected with ease

Our Commitment as an Equal Opportunity Employer

As a mission‑led technology company helping to drive better healthcare outcomes, Abacus Insights believes that the best innovation and value we can bring to our customers comes from diverse ideas, thoughts, experiences, and perspectives. Therefore, we dedicate resources to building diverse teams and providing equal employment opportunities to all applicants. Abacus prohibits discrimination and harassment regarding race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

At the heart of who we are is a commitment to continuously and intentionally building an inclusive culture—one that empowers every team member across the globe to do their best work and bring their authentic selves. We carry that same commitment into our hiring process, aiming to create an interview experience where you feel comfortable and confident showcasing your strengths. If there’s anything we can do to support that—big or small—please let us know.

AI Use in Recruitment

We use AI‑powered tools throughout our recruitment process. This includes Greenhouse's Real Talent Matching Technology, which helps prioritize applications based on job‑related criteria, as well as additional AI tools used to support sourcing, interview preparation, and other recruiting tasks. We do not remove the human element—our recruiters and hiring teams review all applications and make all decisions related to candidate progression and hiring, regardless of which tools are used to support that process.

Identity and Location Verification

To protect the integrity of our hiring process, all interviews are conducted by live video with your camera on. Virtual or blurred backgrounds and headsets are not permitted absent an approved accommodation, and you should be in a well‑lit, private space where your face and surroundings are clearly visible. Candidates who advance may also be asked to complete identity and location verification, which may include verifying your identity, work history, and confirming that you are located where your application states. Applications containing knowingly false or materially misrepresented information, including identity, location, or credentials, may be disqualified, and any offer may be rescinded if a material misrepresentation is discovered at any point in the process.

I f you need an accommodation for any part of the interview process, please let your recruiter know in advance.

By applying, you acknowledge that we will collect and process your personal information for recruiting purposes in accordance with applicable data protection laws, including for the verification steps described above. Please review our Applicant Privacy Notice for more information, including your rights.