Senior Consultant, Health Care Data Analytics

COPE Health Solutions; Los Angeles (CA); On-site; USD 112,000 - 139,000; Full time

Benefits offered by this job

Wellness stipend

Paid parental leave

Insurance plans

Job summary

COPE Health Solutions in Los Angeles/New York seeks a Senior Consultant to lead cross-functional analytics workstreams for value-based care engagements, designing, developing, maintaining, and executing dashboards, reports, and scorecards.

You will translate requirements, ensure data quality, present findings to executives, mentor junior staff, and leverage AI-enabled tools to accelerate analytics.

Qualifications

• Graduate degree preferred in a quantitative/healthcare/technical field.
• 3+ years of healthcare analytics experience in consulting, health system, or payer.
• Experience with healthcare claims and eligibility data.
• Familiarity with EMR/Utilization Management datasets preferred.
• Proficiency in SQL and BI platforms.
• Knowledge of value-based care programs (MSSP, ACO REACH, MA).
• Experience using AI tools to enhance analytics and reporting.
• Strong communication and stakeholder management skills.

Responsibilities

• Design, develop, automate, and maintain dashboards and reports for clients and internal use.
• Translate requirements into scalable reporting solutions using SQL, Excel, and BI tools.
• Analyze healthcare data to identify opportunities across quality, utilization, and cost.
• Create executive-ready reporting highlighting outcomes and opportunities.
• Validate data completeness, accuracy, and adherence to business rules.
• Collaborate with product, engineering, consulting, and implementation teams on data mapping and logic.
• Investigate data anomalies and recommend quality improvements.
• Support new reporting capabilities for MSSP, ACO REACH, MA, and Medicaid value-based programs.
• Present findings to technical and executive audiences in a clear, actionable manner.
• Leverage AI to accelerate report development and automate processes.
• Contribute to continuous analytics modernization and efficiency improvements.
• Provide quality oversight for junior team members; project leadership or mentorship.

Skills

SQL

Healthcare analytics

Stakeholder management

Executive presentation

AI tooling

Data visualization

Project management

Dashboard design

Excel

Education

Graduate degree (quantitative, healthcare, business or technical)

Bachelor's degree with applicable experience

Tools

SSMS/SQL Server Tools

Excel

Job description

The Senior Consultant will work with cross-functional teams in a centralized consulting role supporting multiple client engagements and internal operational initiatives. The Senior Consultant is responsible for independent ownership of major analytical workstreams as well as defining methodology and reporting logic. This include s, but is not limited to, designing, developing, maintaining, and executing healthcare analytics and reporting solutions that enable clients and internal leadership to evaluate performance, identify opportunities, and improve outcomes across value-based care programs.

This position partners closely with consulting, product, engineering, clinical, and client stakeholders to translate complex healthcare data into meaningful insights that drive operational efficiency, quality improvement, utilization management, care management performance, risk adjustment optimization, and financial success. The ideal candidate must be accountable for deliverable quality and deadlines, comfortable with direct presentation to client executives, possesses deep healthcare data expertise, SQL development skills, strong analytical thinking, and an ability to leverage AI-enabled technologies to improve reporting and analytics capabilities.

FLSA Status

Exempt

Salary Range

$111,600 - $139,400

Reports To

Director, Medical Economics

Direct Reports

None

Location

Hybrid in LA/NY Office

Travel

Up to 40%

Work Type

Regular

Schedule

Full Time

Position Description

• Design, develop, automate, maintain, and execute client-facing and internal dashboards, reports, scorecards, and recurring analytics supporting value-based care initiatives.
• Translate client and stakeholder business requirements into scalable reporting and analytical solutions using SMSS SQL, Excel, and other business intelligence tools.
• Analyze healthcare claims, EMR, and operational datasets to identify actionable opportunities related to quality performance, care management, utilization management, prior authorization, HCC risk adjustment, population health, and medical cost/utilization.
• Develop executive-ready reporting that highlights operational efficiencies, outcomes, successes, failures, emerging trends, and strategic opportunities.
• Validate healthcare data for completeness, accuracy, consistency, and adherence to business rules while ensuring reporting integrity and reproducibility.
• Collaborate with product, engineering, consulting, and implementation teams to map client-specific data elements and define reporting logic aligned with client requirements.
• Investigate data anomalies, perform root cause analyses, and recommend solutions that improve data quality and accurate reporting.
• Support implementation of new reporting capabilities for value-based care programs including MSSP, ACO REACH, Medicare Advantage, Commercial Risk, and Medicaid value-based arrangements.
• Present analytical findings to both technical and executive audiences in a clear, actionable manner.
• Utilize AI-enabled technologies to accelerate report development, optimize SQL coding, improve documentation, automate repetitive analytical processes, and identify innovative opportunities for enhancing client value.
• Contribute to continuous improvement initiatives that modernize analytics capabilities, increase operational efficiency, and strengthen consulting delivery.
• Review or quality oversight of junior team members.
• Project leadership or information mentorship.

Qualifications

• Graduate degree with a quantitative, healthcare, business or technical focus preferred, bachelor’s degree and applicable experience will be considered.
• 3+ years of professional experience performing healthcare analytics within a consulting firm, health system, payer, accountable care organization, or healthcare technology organization.
• Demonstrated experience working with healthcare claims and eligibility data (professional, institutional, and pharmacy).
• Experience with Electronic Medical Record (EMR/HER) and Utilization Management and Prior Authorization datasets preferred
• Proficiency in SQL
• Familiarity of data visualization and Business Intelligence platforms
• Working knowledge of value-based care programs and healthcare risk-based arrangements including MSSP, ACO REACH, Medicare Advantage, and alternative payment models.
• Experience supporting HCC Risk Adjustment, quality, care management reporting, and utilization management analytics.
• Strong consulting, project management, and stakeholder relationship management skills.
• Experience utilizing AI technologies (e.g., ChatGPT, Microsoft Copilot, Claude, GitHub Copilot, or similar tools) to improve analytics development, SQL optimization, reporting automation, and operational efficiency.
• Excellent written and verbal communication skills with the ability to explain technical concepts to both technical and business audiences.

Benefits

As a firm passionate about health care, we’re deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities, and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/

About COPE Health Solutions

COPE Health Solutions is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers, health plans and self-insured employers. For more information, visit https://copehealthsolutions.com/about-us/