Domain Expert - HealthCare

Healthcare Payer and Provider Data and Analytics space.

Key Responsibilities:

Value-Based Care Strategy & Implementation

• Champion data and analytics solution offerings across value-based care, care management, member engagement, clinical and claims analytics.
• Advise payers and providers on operational analytics, population health, utilization management, and care coordination to enable VBC success.

Data-Driven Insights & Performance Optimization

• Collaborate with data engineering and analytics teams to design dashboards and AI-driven predictive models for patient stratification, readmission prevention, and cost optimization.
• Shape next-gen solutions leveraging Agentic AI for clinical decision support, prior authorization, claims adjudication, and RCM workflows.
• Provide strategic guidance on integrating EHR, claims, and SDoH data to deliver measurable improvements in quality and cost outcomes.

Stakeholder Engagement & Advisory

• Drive requirement discussions, solution strategy, scope and approach to evangelize the solutions development with technical team.
• Support sales and business development teams by providing subject matter expertise in client discussions, RFP responses, and solution demonstrations.

Regulatory Compliance & Market Trends

• Stay updated on healthcare policies, CMS regulations, and emerging VBC trends to ensure clients remain compliant and competitive.
• Conduct industry research and contribute to whitepapers, webinars, and client education sessions on value-based care strategies.

Required Skills and Experience:

Domain Expertise

• Deep understanding of value-based care models, population health management, and risk-based payment arrangements.
• Experience with payer-provider integrations, data and analytics modernization requirements to drive customer use cases

Technical & Analytical Proficiency

• Knowledge of healthcare data sources, including claims, EHR, Labs, HIEs, and SDoH.
• Experience with data analytics, AI/ML in healthcare, and performance measurement tools (e.g., Power BI, Tableau, Databricks, Azure, AWS).

Communication & Leadership Skills

• Strong ability to engage with executive-level stakeholders and translate complex VBC concepts into actionable strategies.
• Excellent presentation and writing skills for client engagements, proposals, and thought leadership.

Industry Experience

• 8-10 years of experience in healthcare consulting, payer or provider organizations, or health tech firms focusing on value-based care.
• Experience in crafting solution offerings, detailing requirements, scope and coming up with right messaging and value proposition

Preferred Qualifications:

• Bacheleor’s or Master’s degree in Engineering, Business, Data Science or related field.
• Certifications in value-based care, population health, or healthcare analytics (e.g., CHIE, CPHIMS).

Experience working with health systems, ACOs, or payers on VBC program implementations.