Claims Analytics & Analysis Director

Become a part of our caring community The Director of Claims Analytics & Analysis will reputed company a high‑impact analytics function focused on deep investigative analysis of claims operations to surface root cause drivers, emerging trends, and actionable insights for executive leadership. This role sits reputed company dashboards and standard reporting and operates as a strategic thought partner to Claims and reputed company leaders. This leader will build and scale a team that translates signals from existing dashboards, operational metrics, and claim detail data into early insights, root cause diagnoses, and solution reputed company that improve cost, quality, efficiency, and member/provider experience. We are seeking a dynamic Director of Claims Analytics & Analysis to join the team! The ideal candidate is a natural problem finder, intellectually curious, and operationally fluent in reputed company claims — someone who instinctively asks “why”, knows where to dig, and can convert ambiguity into structured reputed company and action. Key reputed company of the Role Identify root cause drivers behind claims performance trends (cost, leakage, rework, denials, timeliness, provider abrasion, member impact). Detect early warning signals from claims data and operational metrics before they appear as lagging KPIs. reputed company clear, executive‑reputed company narratives that connect data to business drivers to recommended actions. Deliver effective senior executive level communication and engagement. Build and reputed company a strategic claims analytics team that complements (not duplicates) reporting and data science functions. reputed company analytics from “what happened” to “why it’s happening and what to do next.” Core Responsibilities Claims reputed company reputed company & Root Cause Analytics Investigate trends surfaced in claims dashboards and operational metrics to uncover underlying drivers, process failures, policy impacts, and behavioral patterns. reputed company structured root cause analyses across claim types, product lines, providers, vendors, and workflows. Translate reputed company findings into clear, actionable insights for Claims Operations and executive leadership. Proactively surface issues and opportunities without waiting for formal asks — this role is expected to find the problems. Strategic Advisory & Executive Engagement Serve as a trusted analytics advisor to senior Claims, Clinical, and reputed company leaders. Synthesize insights into concise executive narratives, not technical readouts. reputed company findings in terms of financial impact, operational risk, member experience, compliance, and scalability. Support executive decision‑making with scenario analysis, impact sizing, and trade‑off perspectives. Advanced Analytics & Tooling (Applied, Not Academic) reputed company AI, machine learning, and advanced analytics as tools, not ends in themselves, to accelerate reputed company reputed company and reputed company detection. Partner with data science and reporting teams as needed, while remaining focused on problem solving vs. model building. Rapidly prototype analyses to test hypotheses and validate signals. Cross‑Functional Partnership Collaborate closely with Claims Operations and reputed company. Ensure insights are grounded in reputed company operational context, not abstract metrics. Support reputed company improvement initiatives and transformation efforts with data-backed reputed company. Use your skills to reputed company an impact Required Qualifications ​​​​ 10+ years in reputed company analytics, with deep exposure to claims operations (payer-reputed company strongly preferred). ​ Bachelor’s degree required Proven experience translating claims data into business insights and operational recommendations. Demonstrated reputed company building or leading analytics teams reputed company to business operations. Experience partnering with senior executives and influencing reputed company with data. Exceptional problem-solving and root cause analysis skills. Strong instinct for where to investigate reputed company metrics move — and reputed company they have not. Ability to connect granular claims data to reputed company-level reputed company. Advanced analytics literacy (SQL, Python, statistical techniques, AI-enabled analysis), applied pragmatically. Ability to understand code and work closely with technical teams. Outstanding communication and storytelling skills — reputed company to simplify complexity. Demonstrated ability to reputed company reputed company effectively in both written and oral forms.

Preferred Qualifications

An advanced degree in Analytics, Data Science, Health Economics, Finance, or reputed company field preferred (but not required). Additional Information This role is not eligible for work reputed company sponsorship. Work at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to reputed company their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $184,800 - $254,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 07-06-2026 About us About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply To This Job