COMPANY OVERVIEW
Harbor Health is on a mission to disrupt the outdated US healthcare system. Leveraging a revolutionary payvidor model, we are creating an entirely new approach to care--one that delivers improved quality, reduced cost, greater access, and an exceptional experience. Our vision is supported by intelligent, anticipatory clinical systems and aligned benefits that place the member at the center. If you're inspired by the opportunity to rebuild healthcare from the ground up with cutting-edge technology and a member-focused mindset, we want to hear from you!

POSITION OVERVIEW
We're seeking an Insurance Analyst / Analytics Engineer to drive actionable intelligence across our integrated insurance operations. This will include work across clinical management revenue operations, risk adjustment, utilization management, pharmacy, and member retention. This is a high-visibility, high-impact role at the intersection of payor economics, population health, and data-driven operations. You will also collaborate to enhance our data infrastructure & operations to improve the usability of our data assets. You will closely work with teams across the organization, including Product, Data, Engineering, and Operations. This role combines analytical thinking with hands-on data execution to support Harbor Health's mission of transforming healthcare in Texas.

POSITION DUTIES & RESPONSIBILITIES

General Responsibilities

• Build and maintain the semantic layer/metrics; define KPI logic and reusable models that power dashboards and self-serve reporting.
• Translate business questions into performant SQL and polished dashboards in our BI tool (Omni); ship clean, drill-friendly reports.
• Collaborate with stakeholders to customize reporting and data workflows.
• Help implement and monitor ETL/ELT to land and transform data from databases, files, and APIs.
• Manage schema changes and migrations with version control and backward-compatible rollouts.
• Develop and deploy forecasting models (e.g., regression, time-series) to power forecasting reports and alerts.
• Collaborate with data engineering team to support on business logic as part of typical build processes.

Representative Analytics

• Own monthly KPI reporting revenue operations including net premium PMPM, retro eligibility adjustments, grace-period exposure PMPM.
• Monitor enrollment integrity and subsidy reconciliation, flagging financial exposure from ineligible members, retro adjustments, or APTC grace-period risk.
• Build and maintain financial models that incorporate leading indicators (auth data, ADT feeds, pharmacy claims) into forward-looking cost projections.
• Produce and maintain core utilization metrics: PCP visits/1,000, specialist visits/1,000, ER visits/1,000, avoidable ER rate, readmission rate, LOS, and LOC.
• Develop leading indicator dashboards using pre-claims data source (e.g., ADT feeds, authorization data, eligibility checks Athena, Zus, and pharmacy-claims).
• identify and continuously monitor high-cost claimants using a multi-signal approach; paid and inventory claims, auth data, ADT, pharmacy, and EMR data.

DESIRED PROFESSIONAL SKILLS & EXPERIENCE

• 3-6 years of experience in healthcare analytics within a managed care, health plan, or payvidor environment.
• Deep familiarity with payor data structures: claims, eligibility/834 transactions, authorization data, ADT feeds, and risk adjustment data.
• Strong SQL proficiency; experience querying data warehouses such as Snowflake.
• Demonstrated ability to build and maintain PMPM-based reporting, utilization analytics, and population health dashboards.
• Understanding of ACA-specific constructs: APTC grace periods, CSR tiers, risk adjustment under the V28 model.
• Ability to translate complex analytics into clear, actionable narratives for operational and executive audiences.
• Experience with data visualization tools such as Omni, Looker, PowerBI, etc.
• Familiarity with EMR data (Athena preferred) and multi-system data integration across clinical and financial sources.
• Experience building ETL/ELT and data processing pipelines using dbt. Familiarity with data orchestration tools such as Airflow or Dagster are a plus.
• Hands-on experience with relational databases and data warehouses.
• Understanding of data modeling principles (star/snowflake schema, normalization/denormalization).
• Familiarity, excitement and comfort working in the HealthTech industry; strong plus if already familiar with key healthcare data concepts.
• Interest and understanding in Harbor Health's "payvidor" business model, and the enormous impacts it will have on the American healthcare system.

WHAT WE OFFER 

• Transformational impact: Be at the forefront of reimagining healthcare operations and payment models.
• Leadership and Ownership: Shape operational strategies in a dynamic, fast-paced environment with high autonomy.
• Collaborative Culture: Join a team that values innovation, integrity, and collective success.
• Competitive Compensation & Benefits: We reward top talent with robust pay, benefits, and growth opportunities.
• Remote Flexibility: Work from anywhere while staying closely connected to a mission-driven team.
• Inclusive Environment: We celebrate diverse perspectives and are committed to creating an equitable workplace.

Harbor Health is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law. We are committed to creating an inclusive environment for all clinicians and teammates and actively encourage applications from people of all backgrounds.