Medical Economics Analytics Manager

Overview

Lead medical economics analytics for international health insurance by identifying drivers of medical cost and utilization trends and translating findings into actions that improve affordability and health outcomes. The role combines healthcare claims expertise, advanced analytics, data visualization, and stakeholder leadership.

What you'll do

• Lead analysis of medical cost and utilization trends across markets, clients, providers, populations, and clinical categories.
• Apply healthcare claims knowledge to distinguish the effects of utilization, unit cost, provider mix, service mix, disease burden, benefit design, and member behavior.
• Develop analytics covering provider performance, population risk, claims leakage, clinical variation, and potential fraud, waste and abuse.
• Convert analytical findings into clearly defined opportunities supported by evidence, expected impact, and recommended next actions.
• Partner with Network teams to support provider benchmarking, contracting strategies, and provider negotiations.
• Partner with Clinical teams to identify opportunities related to care pathways, disease management, utilization management, and site-of-care optimization.
• Partner with Fraud, Waste and Abuse teams to identify abnormal billing, utilization, and provider behaviour patterns requiring further investigation.
• Present complex analytical findings to senior stakeholders in a concise, decision-oriented format.
• Track whether implemented actions deliver the expected impact and use the results to improve future analyses.
• Define and develop self-service dashboards that enable users to identify and investigate medical cost and utilization drivers more quickly.
• Translate business questions into analytical requirements, measures, drill-down pathways, and intuitive dashboard designs.
• Work with Data and Technology teams to ensure analytics products are scalable, reliable, and supported by appropriate data controls.
• Lead, coach, and develop a team of analysts and data specialists.
• Set analytical priorities based on business value, feasibility, and stakeholder needs.
• Review analytical approaches and outputs to ensure accuracy, consistency, and actionability.
• Collaborate with actuarial, finance, data, and analytics teams to reuse existing capabilities and avoid duplication.

What you'll need

• 10+ years of experience in health insurance claims analytics, medical economics, actuarial analytics, or health insurance consulting, including experience leading analytical projects or teams.
• Strong understanding of healthcare claims data, including diagnosis, procedure, provider, place-of-service, utilization, unit-cost, and member-level information.
• Experience using a visualization platform such as Qlik Sense, Power BI, or Tableau.
• Hands-on proficiency in SQL.
• Experience working with large, complex claims datasets.
• Strong written, verbal, presentation, and stakeholder-management skills.

Details

• Location: Bengaluru, India.