Sr. Strategic Healthcare Advisor

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.