Health Plan Ops Analyst

About Curative

Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*. Backed by our recent $150M in Series B funding and valuation at $1.275B Curative is scaling rapidly and investing in AI-powered service deeper member engagement and a smart network designed for todays workforce.

Our north star guides everything we do: healthcare only works when people can actually use it. That belief drives every decision we make: from how we design our plan support our members to how we collaborate as a team.

If you want to do meaningful work with a team that moves fast experiments boldly and cares deeply Curative is the place to do it. Were growing fast and looking for teammates who want to help transform health insurance for the better.

SUMMARY

We are seeking a detail-oriented and proactive Health Plan Operations Analyst to play a pivotal role in optimizing our office and customer business operations. This role requires a strategic thinker with the authority to formulate interpret and implement management policies and operational practices. The successful candidate will be responsible for major assignments in the organizations operations provide expert consultation to management and be actively involved in planning both long- and short-term organizational objectives. The role also involves investigating and resolving significant issues on behalf of management.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Strategic Operations Management:

• Policy and Practice Formulation: Develop interpret and implement management policies and operating practices to enhance organizational efficiency and effectiveness.

• Operational Oversight: Lead major assignments that directly impact the organizations operations ensuring alignment with strategic objectives.

• Consultation and Expert Advice: Provide expert consultation and advice to management on operational matters contributing to strategic planning and decision-making.

• Project Management and Build: Manage projects related to data analysis and reporting ensuring timely delivery and alignment with organizational goals. Oversee the development and implementation of reporting tools and systems coordinating with IT and other departments as needed.

Data and Reporting Management:

• Data Analysis: Examine health plan data to identify trends discrepancies and opportunities for process improvement.

• Report Creation: Design and maintain comprehensive reports and dashboards reflecting key performance indicators (KPIs) financial metrics and operational efficiency.

• Strategic Recommendations: Deliver actionable insights and recommendations based on data analysis to support strategic and operational decisions.

Compliance and Quality Assurance:

• Regulatory Adherence: Ensure organizational compliance with regulatory requirements and internal policies through diligent monitoring and audits.

• Quality Control: Oversee quality metrics and perform audits to validate the accuracy and effectiveness of operational processes.

Operational Support:

• Network and Access Evaluation: Evaluate network additions and access improvements in coordination with all ops departments.

• Process Improvement: Assess and enhance current operational processes and workflows collaborating with cross-functional teams to implement and track improvements.

• Initiatives and Systems: Assist with the implementation and management of new operational initiatives and systems working closely with Legal and Compliance departments.

Stakeholder Communication and Liaison:

• Reporting: Prepare and present findings reports and recommendations to management and stakeholders ensuring clarity and alignment with organizational goals.

• Cross-Departmental Liaison: Act as a liaison between operations and other departments fostering effective communication and collaboration across the organization.

Strategic Planning and Recommendations:

• Trend Monitoring: Stay current with industry trends best practices and technological advancements to drive operational improvements.

• Process Enhancement: Lead initiatives to streamline processes and improve operational effectiveness collaborating with cross-functional teams.

• Provide actionable insights and recommendations based on data analysis to support strategic decision-making.

• Contribute to the development of operational strategies and initiatives to improve performance.

QUALIFICATIONS

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:

• Technical & Analytics Proficiency

  • Advanced proficiency in Microsoft Office (Excelincluding Power Query pivot tables and advanced formulasWord Access) and Google Workspace. Strong working knowledge of data analytics tools such as SQL Python and/or R along with experience using BI and visualization platforms (e.g. Power BI Tableau Looker). Familiarity with cloud-based data environments and data integration workflows.

• AI & Automation Enablement

  • Hands-on experience leveraging AI tools and large language models (e.g. Claude ChatGPT Copilot) to support data analysis research documentation summarization workflow automation and decision support. Ability to apply AI responsibly to improve efficiency insight generation and accuracy in business and healthcare analytics contexts.

• Commercial Health Plan Experience

• Payment Systems Expertise: Strong understanding of provider payment systems reimbursement methodologies and payment reconciliation processes. Proficient in medical coding standards including ICD CPT and HCPCS and their application within claims adjudication and analytics.

• Health Plan Operations Knowledge: Comprehensive knowledge of health plan operations including end-to-end provider claims and payment systems data flows and regulatory considerations with the ability to translate operational data into actionable insights.

• Analytical Acumen: Advanced ability to analyze large complex datasets; identify trends risks and opportunities; and deliver data-driven insights that inform strategy operational improvement and financial performance.

• Communication & Data Storytelling: Excellent written and verbal communication skills with the ability to translate complex analytical findings into clear concise and compelling narratives for technical and non-technical audiences including leadership and external stakeholders.

• Interpersonal Skills: Strong interpersonal skills with a professional demeanor and demonstrated ability to build trust collaborate cross-functionally and maintain productive relationships across diverse teams and partners.

• Problem-Solving & Critical Thinking: Proven ability to define complex problems evaluate data-driven options and implement effective scalable solutions that address root causes and support organizational goals.

• Time Management & Execution: Demonstrated ability to manage competing priorities meet deadlines and deliver high-quality work in fast-paced environments with a strong sense of ownership and urgency.

• Adaptability & Continuous Learning: Highly adaptable with the ability to manage multiple initiatives pivot in response to changing priorities and continuously learn emerging analytics techniques healthcare regulations and AI capabilities.

• Professional Presence and Leadership Interaction: Skilled in interacting effectively with all levels of management and across organizational layers contributing as both an independent contributor and collaborative team member.

EDUCATION and/or EXPERIENCE

• Bachelors degree in Health Administration Business Administration Data Science or a related field.

• Experience: Minimum of 2-3 years of experience in health plan operations data analysis or a related role. Experience with health insurance and managed care is highly preferred.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this Job the employee is regularly required to sit; use hands to handle or feel; talk; and hear.

• The employee is frequently required to reach with hands and arms.

• Specific vision abilities required by this job include close vision distance vision color vision peripheral vision depth perception and ability to adjust focus.

• The noise level in the work environment is usually: Mild

Perks & Benefits

• Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)

  • $0 copays and $0 deductibles (with completion of our Baseline Visit )

  • Preventive and primary care built in

  • Mental health support (Rula Televero Two Chairs Recovery Unplugged)

  • One-on-one care navigation

  • Chronic condition programs (diabetes weight hypertension)

  • Maternity and family planning support

  • 24/7/365 Curative Telehealth

  • Pharmacy benefits

• Comprehensive dental and vision coverage

• Employer-provided life and disability coverage with additional supplemental options

• Flexible spending accounts

• Flexible work options: remote and in-person opportunities

• Generous PTO policy plus 11 paid annual company holidays

• 401K for full-time employees

• Generous Up to 812 weeks paid parental leave based on role eligibility.