Claims Based Health Outcomes Consultant

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New York City, NY
Job Type
Direct Hire
Jun 12, 2017
Job ID

Lead Consultant for Administrative Claims Based Health Outcomes Research

Consultant (Non-Actuarial)

NYC Health Practice consults to clients on the financial and utilization characteristics of disease processes and treatments as well as healthcare reform, risk arrangements, and payer systems. Our clients span all sectors of the health industry. Our services include analyzing financial arrangements, innovative contracts, disease states, therapeutic value, benefit design, healthcare reform, and health systems. We have brought unparalleled actuarial, analytical, and operational expertise to these clients. World’s premier actuarial consulting firm with over 3,000 employees and $800 million in revenue. We attribute our 60+ years of continuous growth to our environment where independent and talented individuals succeed as outstanding professionals. We have a collegial, rigorous, supportive and non-bureaucratic environment.
Do you have the analytic skills and insights to find what our clients are looking for in a pile of health plan administrative claim data? Do you have current experience designing and leading research based on at least one of the following databases: Truven MarketScan commercial, CMS Medicare 5% and 100% samples or health plan administrative claims data?  Do you thrive in a fast-paced environment? NYC Health Practice is seeking professionals from a variety of analytic and clinical backgrounds to join our vibrant staff and data-rich environment. We offer challenging projects, world-class resources, expert colleagues, a collaborative environment, and diverse client projects. Work, learn, and grow with us.

We seek energetic and imaginative professionals to join our client-oriented team in New York City. Successful candidates will have the potential to become practice leaders and become recognized as expert senior consultants.


Primary roles:

  • Develop claims-based methodologies for administrative claim based studies
  • Collaborate with and supervise best-in-class data analysts
  • Apply your experience to a wide array of healthcare system topics including healthcare reform
  • Help manage and develop clients among ACOs, insurers, and bio-science
  • Assist junior colleagues with the development of their programming and analytic skills
  • Author client reports and publications for peer-reviewed journals


  • Required:
    • Advanced degree OR at least five years of experience in the field.
    • PharmD, RN, MD, MPH, MS, PhD, FSA, ASA or similar background
    • Current experience with MarketScan and/or Medicare (or similar) administrative claims databases.
    • Excellent understanding of medical coding systems (CPT, ICD, DRG, etc.)
    • Experience with healthcare finance and payer systems.
    • Comfortable performing literature searches, creating analysis plans, and writing reports for a wide array of healthcare topics.
    • New York City location; this job requires working with colleagues in our office.  Limited travel—working at client site is rare.
  • Preferred:
    • Experience in insurance, finance, or outcomes research
    • Experience programming in SAS/SQL.
    • Knack for prioritizing and completing multiple projects and tasks
    • Strong problem solving and analytical skills
    • Strong oral and written communication skills
    • Ability to work both independently and as part of a team

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.

Required Education

Bachelors or better in Other.


Masters or better in Public Health or related field.

PharmD or better in Pharmaceuticals or related field.



Current experience with MarketScan and/or Medicare (or similar) administrative claims databases.

Excellent understanding of medical coding systems (CPT, ICD, DRG, etc.)