Senior Claims Data Analyst
We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.
Summary of the Role:
The Senior Claims Data Analyst will play a pivotal role in enhancing the efficiency and scalability of our claims operation. This individual will drive insights through advanced analytics and develop high-impact reporting and dashboards. Partnering closely with the claims operations team, the analyst will identify opportunities for process improvement and own the analytics that empower our operations and leadership teams to succeed. This individual will go beyond surface-level reporting to identify patterns, uncover root causes, and drive strategic improvements that enhance operational efficiency, service delivery, and customer satisfaction.
Responsibilities Include:
Collaborate with claims and stop loss operations teams to understand analytics and reporting needs that drive efficiency and scalability.
Scope, gather, and structure requirements into actionable opportunities and solutions.
Extract, manipulate, and analyze large datasets from claims databases using SQL or similar querying languages.
Translate data into actionable insights and strategic recommendations that inform process improvements, resourcing decisions, and operational priorities
Develop models and algorithms to identify trends, anomalies, root causes of inefficiencies and areas for operational improvement.
Design and maintain scalable dashboards and reports using tools like Tableau, Power BI, or similar platforms.
Create and monitor productivity and performance metrics to assess and enhance departmental efficiency.
Present findings to operations leadership with clear narratives that tie analytics to business outcomes.
Serve as a technical liaison between claims operations and the core data team to ensure accuracy and quality in analytics.
Develop and maintain SLA reporting to ensure claims operations meet and exceed client expectations.
Proactively identify and recommend areas for automation, workflow enhancements, and optimization across the claims lifecycle.
Ensure data integrity and accuracy across all analyses.
Required Skills and Abilities:
Proficiency in SQL with the ability to write complex queries and manipulate large datasets.
Strong skills in Python or R for data analysis and insight generation.
Strong skills in building interactive dashboards using Tableau, Power BI, or equivalent tools.
Familiarity with data warehousing and cloud platforms (e.g., AWS, Snowflake).
Exceptional attention to detail and commitment to data accuracy.
Critical thinking and structured problem-solving abilities.
Strong interpersonal skills for effective collaboration across operations, IT, and business teams.
Excellent verbal and written communication skills, with the ability to translate technical findings into business-friendly language.
Education and Experience:
Bachelor’s degree in Data Science, Statistics, Healthcare Administration, or a related field.
5 years of experience in data analytics, preferably within healthcare or insurance claims operations.
5 years of experience in healthcare, claims processing, stop loss reporting and data needs and relevant regulations (e.g., ACA, HIPAA).
Work Location:
This position is remote
Access to Buffalo or NYC office if local
Centivo Values:
Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.
Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.
Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive.
Who we are:
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.
Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.