Senior Product Analyst, Methodology

Description

We are seeking a highly skilled and detail-oriented analyst to serve as a Senior Product Analyst on our Data Methodology team. This role requires deep experience working with healthcare claims data and strong technical capabilities, particularly SQL, combined with an understanding of healthcare coding, billing, and analytical methodologies.

The ideal candidate will be comfortable translating complex healthcare and business requirements into scalable, well-documented analytical logic and partnering closely with engineering, product, and clinical subject‑matter experts.

• Analyze large-scale healthcare claims datasets (primarily closed claims; experience with open claims and remittance data preferred) to support the development and validation of analytical methodologies.
• Design, implement, and optimize complex SQL queries to support methodology development and enhancements for new and existing products, data validation, and ad hoc analyses.
• Validate outputs to ensure accuracy, clinical relevance, and alignment with business and product requirements.
• Develop and maintain analytical rules, measures, and calculations related to utilization, cost, quality, and clinical outcomes.

• Partner with Product, Engineering, and Clinical teams to translate business and clinical requirements into technical specifications.
• Serve as a bridge between business users and technical teams by documenting methodology logic, assumptions, and data flows.
• Support product enhancements and new feature development by evaluating the feasibility and impact of methodology changes.
• Assist with troubleshooting data and methodology issues across upstream and downstream systems.

• Apply knowledge of healthcare claims processing, billing, and coding standards, including CPT / HCPCS, ICD‑10 (CM and PCS), MS‑DRG.
• Leverage experience with clinical groupers and advanced claims methodologies (e.g., risk adjustment, episode groupers, severity adjustment, benchmarking) to inform analytical design.
• Stay current on industry trends, coding changes, and regulatory updates that may impact methodologies.

• 5–8 years of relevant professional experience in healthcare analytics, data analysis, or a related field.
• Advanced SQL proficiency (required), including experience with complex joins, CTEs, window functions, and performance optimization.
• Hands‑on experience working with healthcare claims data.
• Strong understanding of healthcare coding and billing concepts, including CPT/HCPCS, ICD‑10, and MS‑DRG.
• Proven ability to analyze complex data, identify patterns, and translate findings into clear, actionable insights.
• Experience working cross‑functionally with technical and non‑technical stakeholders.

• Experience with clinical groupers and advanced healthcare methodologies (e.g., episode‑based analytics, risk adjustment models, severity stratification).
• Familiarity with healthcare analytics products or platforms.
• Experience with data modeling, requirements documentation, and systems analysis.
• Exposure to modern data warehouses and analytics tools (e.g., Big Query, Data Bricks, etc.).
• Background in healthcare economics, clinical analytics, or population health, or relevant field.

• Analytical rigor and attention to detail.
• Strong written and verbal communication skills.
• Ability to work independently in a fast‑paced, ambiguous environment.
• Curiosity and willingness to dig into complex healthcare and data problems.
• Collaborative mindset with a product‑oriented perspective.