Healthcare Analytics and Client Reporting Lead

About Bluestone Health

Bluestone Health is building a more connected healthcare experience for employer groups and communities, including people in rural and remote areas where access to coordinated care is often limited. Our model brings together health plan administration, pharmacy benefits, primary care, specialty care, and care coordination so members are not left to navigate a fragmented system on their own.

We are using software, data, and responsible AI to make that model work at scale. That includes connecting systems that rarely communicate well, helping care teams identify what needs attention, reducing administrative work, and giving clients a clearer understanding of utilization, cost, and outcomes. Our goal is not to add another digital layer to healthcare. It is to help rebuild how healthcare is organized and delivered so it feels coordinated, responsive, and human.

Our team is small and high-trust. People here have real ownership over work that directly affects patient care, client decisions, and company strategy. There are no layers of analysts handing work from one queue to another. You will work closely with executives, clinicians, operations leaders, clients, and engineers, and you will be accountable for both analytical quality and practical usefulness.

Why Now

Bluestone is expanding its client base and the scope of the care, pharmacy, and administrative services it coordinates. We are receiving more eligibility, claims, prior-authorization, pharmacy, clinical, and operating data, and clients increasingly expect Bluestone to explain what is happening across that information.

The hard part is not producing another dashboard. It is defining measures correctly, understanding what the underlying data can and cannot support, making analyses reproducible, and turning the result into a clear client decision or clinical action.

We are building that capability now. The person who joins will help establish Bluestone's analytics methods, recurring reporting models, and standards for client-facing evidence rather than inheriting a finished reporting function.

The Role

We are looking for a Healthcare Analytics and Client Reporting Lead to turn healthcare data into defensible analysis, repeatable client reporting, and clear recommendations.

This is a senior individual-contributor role. It is not a generic business-intelligence position and it is not primarily a presentation-design job. You will need to understand healthcare claims, eligibility, pharmacy, provider, facility, and utilization data well enough to determine what the fields mean, how measures should be constructed, where the data is incomplete, and what conclusions are supportable.

You will own work from question definition through analysis and communication. That includes clarifying the business or clinical question, inspecting source data, documenting definitions and assumptions, building reproducible SQL-based analyses, validating results with the appropriate domain owners, and presenting the findings in client-ready reports and decks.

You should be comfortable moving between claim-level detail and an executive presentation. A strong result is one that can be rerun next month, explained clearly to a sophisticated client, and defended when someone asks exactly how the number was calculated.

Why This Role Exists

Today, important analyses often require the CTO and other leaders to assemble source data, research healthcare definitions, interpret claims, create calculations, and build the client narrative. That is slow, difficult to repeat, and an unnecessary key-person dependency.

Bluestone needs an accountable owner for the meaning and communication of its healthcare data. The role will make recurring reporting more reliable, shorten the path from a question to a supported answer, and help Bluestone distinguish measured results from assumptions or directional estimates.

What You'll Work On

• Claims and Utilization Analysis: Analyze inpatient, outpatient, emergency department, professional, pharmacy, and related healthcare utilization and cost data.
• Hospital and Provider Analysis: Develop reliable views of hospitals, facilities, clinicians, encounters, levels of care, DRGs, authorization activity, and provider relationships using the source fields available.
• Financial Measure Definition: Define and explain allowed amounts, paid amounts, plan-paid amounts, member responsibility, billed charges, savings measures, and other financial concepts without treating unlike fields as interchangeable.
• Recurring Client Reporting: Build monthly and quarterly reporting models and templates that can be populated consistently across client groups while preserving necessary client-specific context.
• Client-Ready Communication: Turn analyses into direct written findings, charts, tables, presentations, caveats, and recommended actions. Own the analytical story while collaborating with design support when visual polish is needed.
• Measurement Methods: Establish baselines, comparison periods, cohort rules, attribution logic, inclusion and exclusion criteria, and intervention measures that are practical and methodologically honest.
• Reproducible Analytics: Build maintainable SQL queries, analytical models, documented datasets, and repeatable workflows rather than one-time spreadsheets that cannot be traced or rerun.
• Metric Governance: Maintain a catalog of important measures, definitions, data sources, owners, assumptions, validation status, and known limitations.
• Data Validation: Identify gaps, inconsistencies, and source limitations. Work with the Senior Data and Integrations Engineer to determine whether a problem belongs in ingestion, transformation, source mapping, data quality, or analytical interpretation.
• Ad Hoc Analysis: Answer high-value questions from company leaders, clients, clinical teams, and operations. Convert recurring requests into governed models or templates when doing so is useful.
• Client and Executive Partnership: Participate in selected client and internal meetings to clarify questions, explain findings, respond to methodological challenges, and help decision-makers understand tradeoffs.
• Responsible AI: Use AI tools where they improve research, documentation, prototyping, or analytical productivity, while independently verifying calculations, protecting sensitive information, documenting methods, and retaining human accountability for every client-facing conclusion.

What This Role Does Not Own

• Production ingestion, file delivery, and integration incident response
• Application engineering or ownership of the client portal
• Generic sales collateral, brand design, or presentation formatting as a standalone service
• Unsupported clinical, causal, or savings claims that the available data cannot establish
• Every spreadsheet request without prioritization or a defined business decision
• Replacing clinical, actuarial, financial, or legal judgment where specialized review is required

Current Data and Technical Environment

Our current environment includes:

• PostgreSQL and SQL-based analysis
• TypeScript and Node.js data services
• AWS, including S3, RDS, Lambda, ECS, SQS, and CloudWatch
• Eligibility, enrollment, claims, prior-authorization, pharmacy, provider, facility, and operational data
• APIs, SFTP, flat files, and scheduled healthcare data exchanges
• Client reporting in presentation, spreadsheet, and web-based formats

You do not need to be a production software engineer. You do need to be technically independent with healthcare data, capable of building reproducible analysis, and able to work effectively with engineers on source and pipeline issues.

What We're Looking For

Required

• Significant professional experience in healthcare analytics using medical claims, pharmacy claims, payer, TPA, provider, benefits, or health-services data.
• Strong SQL skills, including joining complex datasets, investigating discrepancies, constructing cohorts, validating results, and creating maintainable analytical logic.
• Working knowledge of healthcare claims structure and terminology, including providers, facilities, places and types of service, diagnosis and procedure coding, DRGs, allowed and paid amounts, and member responsibility.
• Experience creating recurring client, payer, provider, employer, or executive reporting from healthcare data.
• Ability to move from an ambiguous question to a documented analytical method, supported result, and clear recommendation.
• Strong analytical judgment, including the ability to distinguish observed facts, calculated measures, estimates, associations, and unsupported causal conclusions.
• Strong written and verbal communication with both technical and nontechnical audiences.
• Experience presenting findings and methodology to clients, executives, clinicians, finance teams, or other demanding stakeholders.
• Ability to create clear, useful tables, charts, spreadsheets, and presentation materials without allowing visual polish to obscure weak methodology.
• A record of documenting metric definitions, assumptions, exclusions, limitations, and validation steps.
• Ability to work independently in a small team, prioritize competing questions, and drive work to completion.
• Residence in the United States, with substantial working-hour overlap with the U.S. team.

Strongly Preferred

• Experience analyzing inpatient, emergency department, outpatient, physician, and pharmacy utilization and cost.
• Experience with employer health-plan reporting, self-funded plans, TPAs, PBMs, care management, population health, value-based care, or health-plan performance.
• Familiarity with ICD-10, CPT, HCPCS, revenue codes, place-of-service codes, DRGs, NPI, TIN, and provider or facility enrichment.
• Experience defining baselines, cohorts, intervention measures, trend analyses, and credible savings or performance methodologies.
• Experience building an analytical data mart, semantic layer, metric catalog, or other governed reporting foundation.
• Familiarity with HIPAA, protected health information, minimum-necessary access, and auditability.
• Experience working directly with large customer groups, healthcare partners, or benefits leaders.

Nice to Have

• Experience with Python or R for statistical analysis, data preparation, or quality assurance.
• Familiarity with BI and visualization tools such as Tableau, Power BI, Looker, Metabase, or comparable platforms.
• Experience with risk adjustment, quality measures, actuarial methods, utilization management, or healthcare economics.
• Experience in a small company or startup where the analytics function was still being established.
• Experience using generative AI safely and effectively as part of an analytical workflow.

How We Work

• Define the question before calculating. We clarify the decision, population, period, source, and intended use before choosing a metric.
• Make the method inspectable. Important numbers need documented logic, source fields, assumptions, exclusions, and validation.
• Say what the data cannot prove. We do not turn correlation into causation or directional estimates into audited savings.
• Build repeatable work. A useful analysis should become easier to rerun and explain, not remain trapped in one person's spreadsheet.
• Communicate directly. Lead with the conclusion, explain material caveats, and do not bury uncertainty in a footnote.
• Preserve healthcare context. Similar-looking fields may have different meanings across a TPA, PBM, EHR, or client source. We investigate before normalizing.
• Use AI ambitiously and responsibly. AI can accelerate analysis, research, documentation, and communication. It does not replace accountable analytical, clinical, or engineering judgment. Sensitive data must stay within approved systems, and every output must be verified before use.

Why This Role

• Build the function: Help establish Bluestone's analytics methods, metric governance, and recurring client-reporting model.
• Visible impact: Your work will directly shape client decisions, care-coordination priorities, and company strategy.
• Meaningful healthcare questions: Work across utilization, access, cost, pharmacy, care delivery, and coordinated-healthcare operations.
• Proximity to decisions: Work directly with the CTO, company founders, clinical leaders, operations teams, engineers, and clients.
• Broad ownership: Own the full analytical path from source question and method through validated result and client communication.
• Small team, high trust: You will have substantial autonomy and a clear opportunity to improve how Bluestone uses data.
• Responsible application of AI: Help determine where AI can improve analytical and healthcare workflows while preserving privacy, traceability, and human accountability.

Security and Compliance

This role will involve protected health information and other sensitive data. The selected candidate must complete required security, privacy, and HIPAA training, follow Bluestone's access and security policies, and work only through approved devices, systems, and access methods.

Expected Hiring Process

1. Application or recruiter introduction: Resume and brief background information.
2. Screening conversation: Healthcare data experience, role alignment, working hours, and mutual questions.
3. Practical analytical assessment: A paid, time-bounded exercise using synthetic or de-identified healthcare data. The exercise will test analytical reasoning, SQL, validation, and communication rather than trivia.
4. Analytical deep dive: Review the assessment, methods, assumptions, caveats, and presentation choices.
5. Final conversation: Remaining questions, logistics, and offer discussion.

We aim to complete the interview process in approximately two weeks once interviews begin.

How to Apply

Send your resume and a brief note. In your note, tell us:

• Why this role interests you.
• About a healthcare analysis or recurring client-reporting system you owned and are proud of.
• How you made the methodology understandable and defensible.
• Your location, time zone, and availability.

We review applications personally. We do not use automated keyword screening to decide who gets considered.

Equal Opportunity

Bluestone Health is committed to providing equal employment opportunities without discrimination or harassment on the basis of race, color, religion, sex, gender, sexual orientation, gender identity, national origin, disability, age, veteran status, or any other status protected by applicable law.