Senior Strategic Healthcare Advisor

Location: This position is located at our Dublin, OH campus with hybrid flexibility.

Who we are

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.  

About the role

We are seeking a highly experienced Senior Strategic Healthcare Advisor/Consultant with deep expertise in health plan administration, advanced healthcare data analysis, and the specific challenges faced by self-funded employer groups. This seasoned professional will play a key role in analyzing complex healthcare data to provide forward-looking insights and strategic recommendations that help clients optimize member health outcomes and health plan strategy. The ideal candidate is a talented orator, curious, forward-thinking, and adept at leveraging advanced technologies including Generative AI (GenAI), to derive meaningful insights and guide decision-making.

What you’ll do (Essential Responsibilities)

·           Data Analysis & Insight Generation:

• Analyze and identify trends, risks and future opportunities across a broad healthcare data set.
• Utilize advanced analytical techniques and tools, including Generative AI (GenAI), to uncover underlying drivers in plan and member experience, clinical outcomes, population health, and cost dynamics.
• Employ pattern recognition to determine which populations are driving costs, understand behavioral/utilization differences, and identify concentrations in specific divisions or locations.
• Validate data findings by probing deeper into anomalies and ensuring data integrity to produce meaningful insights.

·           Strategic Advisory & Future Planning:

• Act as a trusted advisor to clients, providing forward-looking insights into data trends and their implications for future outcomes.
• Identify opportunities to improve member health outcomes and cost management through changes in benefits design, workplace conditions, partner solutions, or technology enhancements.
• Guide clients and their consultant partners in understanding the potential impact of industry shifts, emerging trends, and "what's happening" in the benefits world on their health plans and member populations.

·           Client Engagement & Presentation:

• Craft and deliver compelling presentations that highlight insights and recommendations, emphasizing actionable strategies and measurable results.
• Engage directly with clients and consultants, collaborating with Client
• Engagement (CE) teams to share insights and provide consultative assistance.
• Build and maintain strong client relationships, serving as an adjunct analytical support and peer advisor, including for clients with their own analysts on staff.

·           Healthcare Industry Expertise:

• Leverage deep understanding of health plan administration, the medical and pharmacy payer landscape, and challenges unique to self-funded employer groups.
• Stay abreast of developments in the healthcare and benefits industries that can impact client results, including regulatory changes and emerging best practices.

·           Internal Collaboration & Solution Delivery:

• Collaborate with internal teams (Value Creation, CE, Pods, Product Development, Technology, Actuarial Teams, Data Specialists) to develop and implement tailored solutions addressing identified opportunities.
• Work with data teams to access and analyze data, and with project management and implementation teams to support action plans.

·           Innovation & Technology Utilization:

• Embrace and leverage advanced technologies, including Generative AI, to enhance data analysis and insight generation.
• Engineer effective prompts and queries to develop deeper insights and answer complex questions using GenAI and other analytical tools.

·           All other duties as assigned.

What you’ll bring (Qualifications)

·           Bachelor’s degree in Health Administration, Public Health, Business, Statistics, or a related field

·           4 years of experience in self-funded healthcare space with 8 years in health plan administration, member health population management, with specific experience supporting self-funded employer groups. 

·           Ideal candidate will be a tenured professional with 8 years’ experience, working in consultative and/or analytical roles with a minimum of 4 years in the self-funded healthcare space.

·           Knowledge of the medical and pharmacy payer industry, including experience with claims and eligibility data.

·           Proven expertise in addressing the unique needs and challenges of self-funded employers, with an ability to develop and communicate strategies that address cost management, plan design, and member health outcomes.

·           Strong self-starter mentality with the ability to work independently, manage time effectively, and proactively address client needs.

·           Exceptional communication and presentation skills, with a demonstrated ability to engage senior stakeholders and present data in a clear, impactful way.

·           Proficiency in data presentation tools and analytics platforms (e.g., Tableau, Excel, or similar).

·           Strong problem-solving and interpersonal skills, with a client-centric and proactive approach.

·           Protect and take care of our company and member’s data every day by committing to work within our company ethics and policies

·           Ability to travel to client locations as needed

·           Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently.

·           A high degree of personal accountability and trustworthiness, a commitment to working within Quantum Health’s policies, values and ethics, and to protecting the sensitive data entrusted to us.

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