Lead design and delivery of data-driven provider payment integrity solutions: build descriptive through prescriptive analytics, perform quantitative data deep-dives, develop ML/SQL/SAS/Python-based models and frameworks, translate insights for stakeholders, manage a small analytics team, and support multiple concurrent payer/provider projects.
JD (Job Description) for Solutions Architect for Provider 360 – C2 role About EXL Health Payments Analytics: At EXL Health Payments Analytics Center of Excellence, we are looking for passionate individuals with growth/startup mindset to experiment, fail fast, learn and contribute to our 5 fold growth story of $200M to $1B EXL is considered Special investigation Unit by 6 of top 10 US health insurance companies (~1/3rd US healthcare data is handled by us) helping with error/overpayment detection of the hospital/doctor claims. Unlike typical services and consulting companies we make our revenue from the savings we identify for the client(Commission/Outcome basis). We Productize algorithms and R&D accelerators that are intended to be used across multiple health insurance clients for the above business case. So expect an ecosystem that has : 1. Massive Data Assets (Millions of structured data and thousands of unstructured records processed monthly) 2. Tech investment (On Prem GPUs, Azure, AWS, Databricks, On Prem- Hadoop-Hive, Hive etc) 3. Leadership push to Digitization, Data-led decisions and AI 4. 100+ members Analytics team of data enthusiasts, decision scientists and Business/Subject matter experts. Our Typical day : Monitoring business performance and operations – Problem solve by applying the different analytics levers or involving different teams doing -- ML models, SQL rules, Hospital Profiling, Pattern Mining etc to meet client savings target. The Analytics teams acts as the R&D and Operational excellence team who constantly find new patterns through all the state of art libraries, technologies from SQL queries to LLM agents. About the Role: We are looking for a Self driven Analytics Consultant to join our team of data and domain enthusiasts in Health Care payment integrity. you will get an opportunity to work with various payers and providers and get to know how we reduce provider abrasion and help provider engagement with our innovative and highly scalable solutions. Responsibilities: Ø Ability to design data driven solutions and Frameworks (Descriptive and Predictive) from scratch & consult in a leadership capacity on potential Solutions/Storyboards and POCs Ø Drives business metrics that add to the top-line and/or profitability Ø Perform quantitative and qualitative analysis like (r aw) data analysis, data deep-dives etc. to acquire insights from data Ø Develops Descriptive (reporting) through to Prescriptive Analytics for business monitoring and operational excellence Ø Translates data insights with business stakeholders to communicate and get equivalent business context Ø Applies next-gen technology to all parts of the analytics lifecycle from data extraction, exploratory data analysis, Data Mining and information extraction from unstructured data to visualization & story boarding Ø Manages a small team of data analyst Skillsets: · >7 yrs. of experience in the field of Strategy and Business Optimization background · Post Graduate or MBA (preferred) OR · Graduates in Engineering / Mathematics / Operations Research / Science / Statistics · Experience in the healthcare industry is preferred. · With atleast 7+ years’ experience in analytics using SQL,SAS, Python, basic statistical concepts and analyzing data & interpreting results to the business · Ability to translate and structure business problems to deliver technical solutions · Proven experience working in a fast-paced environment supporting multiple concurrent projects · Collaborative and team player · Desire to work within a fast-paced environment · Ability to work in a team environment and be flexible in taking on various projects
About the TeamEXL is the indispensable partner for leading businesses in data-led industries such as insurance, banking and financial services, healthcare, retail and logistics. We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. We function as one team to make your goals our goals, whether that’s unlocking the value of generative AI or embedding analytics into workflows that reduce risk or power your growth. Clients choose EXL as their transformation partner for many reasons. Our geographic diversity make talent all over the world instantly accessible. Digital accelerators enable unmatched speed-to-value, letting you realize results fast. It’s our people that truly set us apart, though, including the 1,500 data scientists we have dedicated to our generative AI practice. And our more than twenty years of experience in delivering business services, garnering stellar client references, and maintaining a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.
EXL Chennai, Tamil Nadu, IND Office
Chennai, India
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