Health Data Strategist

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Health Data Strategist

Full Time Orange, CA, US

2 days ago Requisition ID: 1100

Salary Range: $175,000.00 To $225,000.00 Annually

Health Data Strategist

Healthcare is increasingly unaffordable for many Americans. Most people believe they have two choices: increasingly expensive, restrictive employer insurance, or an ACA plan that keeps getting pricier. Many don't know there's a third, smarter option .

WeShare Health is that option.

WeShare Health’s mission is to make healthcare simpler, more affordable, and more human. We're a nonprofit, faith-inspired healthcare sharing organization where members contribute monthly to share one another's eligible medical expenses. We're proudly not insurance, and that's the point.

Members access a national network of 1 million physicians at 30 to 60 percent less than comparable traditional insurance. Since 2018, WeShare Health has served more than 100,000 members and shared more than $50 million in medical expenses. Our purpose is clear: people before profit.

WeShare Health is led by senior executives with deep experience across for-profit and nonprofit enterprises. We’re rated 4.6 out of 5 on Google Reviews, rated 4.7 on Trustpilot by members and certified as a Great Place To Work® by our employees. If you have a bias for action, enjoy challenges, and want to disrupt the status quo to make an impact in a massive industry, WeShare Health might be the place for you!

About this role

The Health Data Strategist is a quantitative role responsible for leading the financial and predictive modeling that underpins WeShare 's health sharing programs. This person will own the analytical frameworks used to project healthcare costs, evaluate program sustainability, set contribution (share) levels, model reserves, and quantify risk across the member population - functions traditionally performed by actuarial teams at health plans and insurers, adapted to the health sharing model.

This is a foundational, highly visible role that partners closely with Finance, Utilization Management, Product, Compliance, and executive leadership to ensure that WeShare's programs remain financially sound, competitively priced, and mission-aligned . The ideal candidate combines strong quantitative/statistical modeling expertise with healthcare cost and utilization knowledge, and is comfortable building analytical infrastructure in a growing, evolving organization.

Key Responsibilities

• Build and maintain predictive models to project healthcare utilization, cost trends, and share (contribution) adequacy across member populations and program tiers.
• Develop reserve and liability estimates (e.g., incurred-but-not-reported cost projections) to ensure the organization maintains appropriate financial cushions against future member sharing obligations.
• Model the financial impact of new products, benefit designs, program changes, and member growth scenarios before launch .
• Design and continuously refine pricing/share-level methodologies that balance affordability for members with long-term program sustainability.
• Serve as the organization's subject matter expert on health data analytics, statistical modeling, and quantitative risk assessment.
• Partner with IT/Data teams to define data requirements, improve data quality, and build the reporting and modeling infrastructure needed for ongoing trend and risk analysis.
• Evaluate and recommend data/analytics platforms, statistical software, and third-party data sources (e.g., benchmark cost/utilization databases) to support modeling accuracy.
• Establish data governance practices for how utilization, claims/SMB, and demographic data are captured, validated, and used in financial projections.
• Monitor and analyze healthcare cost drivers, high-cost claimants/SMBs, utilization trends, seasonality, and emerging risk patterns across the member population.
• Quantify the financial risk associated with program design decisions, eligibility guidelines, and benefit/sharing guidelines.
• Identify and communicate early warning indicators of adverse trend , cost drift , or program underperformance.
• Support stress-testing and scenario planning (e.g., high-cost catastrophic events, membership shifts, macro healthcare cost inflation).

Cross-Functional Partnership

• Partner with Underwriting and Product teams to evaluate the financial soundness of new or revised health sharing programs and guidelines.
• Work with Utilization Management and the SMB (Shared Medical Bills) team to incorporate clinical and claims insights into cost and risk models.
• Support Finance with budgeting, forecasting, and long-range financial planning grounded in data-driven projections.
• Collaborate with Compliance and executive leadership to ensure modeling practices and financial assumptions meet applicable regulatory, contractual, and organizational standards.
• Present findings, assumptions, and recommendations to executive leadership and, as needed, the Board in a clear, decision-ready format.

Reporting & Governance

• Develop dashboards and recurring reporting on cost trend , reserve adequacy, share-level performance, and key risk indicators.
• Document modeling methodologies, assumptions, and data sources to support transparency, auditability, and knowledge continuity.
• Continuously validate model performance against actual experience and refine assumptions accordingly.
• Stay current on healthcare cost trends, health sharing/insurance market dynamics, and relevant statistical and regulatory best practices.

Minimum Qualifications

• Bachelor's degree in Actuarial Science, Statistics, Mathematics, Data Science, Economics, Health Informatics, or a related quantitative field.
• 7+ years of experience in healthcare financial modeling, risk analysis, pricing, reserving, or health data analytics within a health plan, insurer, TPA, health sharing organization, or similar risk-bearing healthcare entity.
• 5+ years of leadership, including managing analysts, modelers, or data professionals.
• Demonstrated experience building and maintaining predictive/statistical models for healthcare cost, utilization, or risk.
• Strong knowledge of healthcare cost drivers, claims/SMB data structures, utilization patterns, and reserve/liability estimation concepts.
• Advanced proficiency in statistical/analytical tools (e.g., SQL, R, Python, SAS) and experience translating data into financial and strategic recommendations.
• Demonstrated experience managing departmental budgets, including headcount planning, vendor spend , and operational cost oversight.
• Excellent communication skills, including the ability to explain complex quantitative concepts and modeling assumptions to non-technical executive and Board audiences.
• Ability to build analytical infrastructure and processes, lead change, and create structure in a developing environment.

Preferred Qualifications

• Master's degree in Actuarial Science, Statistics, Biostatistics, Health Economics, Data Science, or a related field.
• Professional actuarial credentials (e.g., ASA, FSA, MAAA) or equivalent quantitative healthcare risk certification strongly preferred.
• Experience building a data strategy, risk modeling, or financial analytics function from the ground up.
• Prior experience in a health plan, managed care organization, TPA, self-funded employer plan, or healthcare sharing organization.
• Familiarity with NCQA, URAC, CMS, ERISA, ACA, HIPAA, or state-level health plan financial/regulatory requirements as applicable to health sharing organizations.
• Experience partnering with Underwriting, Utilization Management, and Compliance teams on program design and risk evaluation.
• Experience with reserve/liability estimation methodologies, trend analysis, and scenario/stress-testing techniques.
• Knowledge of claims operations, provider contracting, coding, billing, or healthcare reimbursement as it relates to cost modeling.

What we offer

• Competitive Salary + Unlimited PTO
• Health, Dental, Vision, 403(b) and Total Rewards
• Ability to make important enhancements to the Healthcare industry.
• Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere.

UHSM is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.