A

AArete

Global management consulting for profitability optimization

Manager – Claims Analytics

Full-TimeUpdated on 10/2/2026
No salary listed
Expert
Bachelor's, Master's
Pune, Maharashtra, India
HybridHybrid work model with flexible in-office attendance.

About the job

Requirements
  • 12+ years of experience in healthcare analytics, payer operations, claims analytics, consulting, or solution delivery, with a bachelor's or master's degree.
  • Strong knowledge of US healthcare, including payer operations, provider finances, benefit design, reimbursement, claims data, and claims processing.
  • Ability to understand complex or unclear business problems, decide on a solution, and lead a technical team with minimal guidance.
  • A strong record of delivering results by setting priorities, managing risks and dependencies, maintaining quality, and completing work on time.
  • Strong analytical skills and the ability to ask the right questions, find trends and unusual results, test assumptions, and turn data into useful findings.
  • Hands-on experience with medical and pharmacy claims, eligibility, provider, pricing, and related healthcare data.
  • Good understanding of reimbursement methods across Medicare, Medicaid, Commercial, and other lines of business.
  • Knowledge of CPT, HCPCS, ICD, DRG, APC, revenue codes, modifiers, and fee schedules.
  • Experience coaching analysts, consultants, data engineers, and developers and giving clear, useful feedback.
  • Ability to review and question technical designs, data models, SQL, analysis, and outputs without being the main developer.
  • Good SQL skills and working knowledge of Power BI, Excel, or similar tools.
  • Clear communication and stakeholder management skills, with the ability to explain complex work to both technical teams and senior leaders.
  • Knowledge of payer operations, provider contracting, healthcare financial analysis, and the checks needed to deliver accurate results.
  • Extensive experience with healthcare data and how to use it to generate useful insights and present to stakeholders.
Responsibilities
  • Lead healthcare claims and analytics projects from understanding the problem through implementation and measuring results.
  • Use payer and provider knowledge to understand unclear business questions, choose the right approach, and make decisions with minimal guidance.
  • Give the technical team clear direction on data needs, analysis, solution design, timelines, and expected results.
  • Coach analysts, consultants, data engineers, and developers on healthcare topics, problem solving, and delivery.
  • Manage day-to-day delivery across payer and provider projects by setting priorities, removing blockers, managing dependencies, and keeping the team on schedule.
  • Analyze utilization, cost trends, reimbursement, network and provider performance, payment accuracy, and areas for improvement.
  • Guide the team in using medical and pharmacy claims, eligibility, provider, contract, pricing, and reference data.
  • Review data models, SQL, analysis, workflows, dashboards, and final outputs to make sure they are accurate, practical, and suitable for the business need.
  • Set clear checks for data and analysis quality, compare results across sources, and document assumptions and limits.
  • Set success measures, track progress, and change the approach when needed to deliver results.
  • Turn large amounts of healthcare data into clear findings and recommendations for decision makers.
  • Work with clients and internal teams to confirm goals, question assumptions, manage expectations, and agree on next steps.
  • Support proposals, project scope, estimates, demonstrations, and client presentations with a strong healthcare point of view.
  • Build reusable methods, guides, and tools that help the team deliver healthcare analytics work consistently.
  • Create business documents and present to stakeholders.
  • Perform other duties as assigned.
Desired Qualifications
  • Familiarity with concepts such as Total Cost of Care (TCoC), Value Based Care (VBC), Provider Networks, and Payment Integrity.
  • Experience supporting practice growth, solution development, or analytics capability expansion.
  • Experience designing automated analytic workflows or ETL processes.
  • Experience with SQL Server, SSIS, Python, Snowflake, or similar data environments.
  • Familiarity with data warehousing concepts and healthcare data architecture.
  • Experience building visual analytics dashboards for ongoing monitoring and reporting.

About the company

AArete is a global management consulting firm that helps clients increase profits by combining strategic profitability improvement, data-driven solutions, and market intelligence. Its approach translates raw numbers into clear, actionable insights and works alongside clients to drive change within compressed timelines. Unlike firms that rely on generic frameworks, AArete focuses on humanizing data and applying insights across all industries and business functions to deliver practical improvements quickly. The company’s goal is to generate measurable profitability growth and better decision-making for clients, guided by empathy and purpose.

Company Size

501-1,000

Company Stage

N/A

Total Funding

N/A

Headquarters

Chicago, Illinois

Founded

2008

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Simplify's Take

What believers are saying

  • AArete won Forbes recognition for 2026, reinforcing client trust and recruiting pull.
  • Headcount reached roughly 562 in March 2026, signaling continued expansion.
  • AWS showcased Doczy.ai in June 2026, validating AArete's healthcare AI product strategy.

What critics are saying

  • AArete depends heavily on healthcare payers; Centene-style client concentration exposes revenue volatility.
  • AI consulting commoditizes fast; Accenture, Deloitte, and AWS partners attack Doczy.ai pricing.
  • A founder-to-CEO transition after 18 years creates execution risk through 2027 integration.

What makes AArete unique

  • Pam Shipley joined in 2026, bringing Centene payer leadership to AArete.
  • Doczy.ai and Payment Intelligence anchor AArete's healthcare-payer analytics moat.
  • Parthenon Capital's 2025 investment backs AArete's consulting scale and M&A expansion.

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Benefits

Unlimited Paid Time Off

Hybrid Work Options

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Parental Leave

Employee Referral Bonus

Commuter Benefits

Professional Certification Support

Paid Vacation

Flexible Work Hours

401(k) Company Match

Growth & Insights and Company News

Headcount

6 month growth

↓ -2%

1 year growth

↓ -2%

2 year growth

↓ -2%
HITshow
Aug 25th, 2026
AArete recognized among Forbes' World's Best Management Consulting Firms for fifth consecutive year.

AArete recognized among Forbes' World's Best Management Consulting Firms for fifth consecutive year. Consulting leader with deep healthcare payer expertise helps clients across a range of industries transform and innovate through data-driven, AI-powered solutions. AArete has been named among Forbes' World's Best Management Consulting Firms 2026, marking the fifth consecutive year the global management and technology consulting firm has received the recognition. AArete was recognized in three areas: Digital Transformation, Data Analytics & Big Data, and Healthcare & Life Sciences. The rankings are based on feedback from clients and senior executives at consulting firms worldwide. The recognition follows AArete's inclusion in Business Insider's 2026 list of America's Top Management Consulting Firms. The company combines consulting expertise with AI-powered solutions to help organizations improve profitability, modernize operations, and accelerate digital transformation. AArete has a particular focus on healthcare payers, working with U.S. health plans across Medicaid, Medicare, ACA Marketplace, and commercial markets to address total cost of care, affordability, and member experience. "AArete's continued recognition reflects the trust our clients have placed in the firm," said Pam Shipley, CEO of AArete. "It is an honor to work with a globally recognized team that has built its reputation on delivering results for clients." Forbes developed its rankings with research firm Statista based on surveys covering multiple industries and consulting functions.

HealthTech HotSpot
Aug 21st, 2026
AArete recognized among Forbes' World's Best Management Consulting Firms for fifth consecutive year.

AArete recognized among Forbes' World's Best Management Consulting Firms for fifth consecutive year. Consulting leader with deep healthcare payer expertise helps clients across a range of industries transform and innovate through data-driven, AI-powered solutions CHICAGO-(BUSINESS WIRE)-#AI - AArete, a leading global management and technology consulting firm, was recently named among Forbes' World's Best Management Consulting Firms 2026. The firm was recognized for its experience and expertise in the categories of Digital Transformation, Data Analytics & Big Data and Healthcare & Life Sciences. This is AArete's fifth consecutive year on the list, which is based on global surveys of clients and leaders at other consulting firms. The most frequently recommended firms earn a place in the rankings, reflecting their expertise, global relevance and consistent performance. The recognition follows AArete's inclusion in Business Insider's America's Top Management Consulting Firms for 2026, based on feedback from more than 25,000 professionals who have direct experience working with consulting firms. Both honors underscore the firm's track record of pairing deep operational expertise with AI-powered solutions including Doczy.ai(TM) and Payment Intelligence(R) to drive profitability improvement and digital transformation for clients across a range of industries. AArete's signature expertise is in the healthcare payer segment, where the firm partners with U.S. health plans across Medicaid, Medicare, ACA Marketplace and commercial lines to manage total cost of care and expand affordability while protecting quality of care and the member experience. "AArete's continued recognition reflects the trust our clients have placed in the firm," said AArete CEO Pam Shipley. "It is an honor to work with a globally recognized team that has built its reputation on delivering results for clients and continues to do so year after year." Forbes developed the World's Best Management Consulting Firms list in partnership with the research company Statista, surveying clients and senior consulting executives across 13 industries and 15 functional areas. Firms were assessed on their performance in specific industries as well as in functional practice areas. About AArete AArete is a global tech-forward management consulting firm specializing in driving profitability improvement, digital transformation, and strategy & change for clients. AArete's solutions are powered by a digital-first mindset, market intelligence and data-driven approach to deliver purposeful change, actionable insights and guaranteed results. AArete humanizes data by translating numbers into actionable insights, helping clients make better decisions and standing by their side to foster change with confidence, empathy and purpose. For more information, visit aarete.com.

Citybiz
Aug 12th, 2026
Pam Shipley named AArete CEO as founder Loren Trimble transitions to board

AArete, a management and technology consulting firm, has appointed Pam Shipley as chief executive officer. Shipley succeeds founder Loren Trimble, who is transitioning to the company's board after growing AArete into a global firm with more than 500 employees since its 2008 founding. Shipley brings over 30 years of healthcare experience, most recently serving as chief strategy officer at Centene Corporation, a Fortune 25 managed care company. During nearly 14 years with Centene, she held multiple CEO roles overseeing operations across several states and led digital transformation initiatives. The leadership change follows a strategic investment from Parthenon Capital in 2025. AArete specialises in advising healthcare payers on cost management and operational performance, aligning with Shipley's background as both an industry executive and former AArete client.

HealthTech HotSpot
Aug 12th, 2026
AArete names healthcare executive Pam Shipley as chief executive officer.

AArete names healthcare executive Pam Shipley as chief executive officer. Global consulting firm's founder Loren Trimble to step down after 18 years of growth and leadership CHICAGO-(BUSINESS WIRE)-#AI - AArete, a leading global management and technology consulting firm, announced today the appointment of Pam Shipley as chief executive officer. A Fortune 25 healthcare executive with more than 30 years of experience, Shipley succeeds AArete founder Loren Trimble, who will transition from his role as CEO to board member. Shipley joins AArete from Centene Corporation, a leading managed care organization, in which she most recently served as chief strategy officer. She spent nearly 14 years at Centene over two tenures where she held multiple CEO roles in Georgia, Missouri and Mississippi and led digital transformation and market expansion across more than 15 markets. Over her three-decade career in healthcare, Shipley has built a reputation as an executive who combines deep operational expertise with technology-enabled innovation, including senior leadership roles at Kaiser Permanente and Sharecare spanning healthcare technology, provider operations and consulting-driven transformation. Recognized for her ability to align strategy, technology and operations to drive growth, Shipley brings to AArete a track record of helping organizations navigate complex transformations in highly regulated, technology-driven environments. "As a former client, I have worked closely with AArete throughout my career and witnessed firsthand the firm's ability to accelerate growth and drive results," Shipley said. "My work has always been personal to me. I've focused on making healthcare more affordable and effective for the people and communities served by health plans. AArete's talented team and proven solutions are uniquely positioned to help clients do exactly that. I'm honored to build on Loren's legacy and excited to continue delivering value for our clients." AArete drives profitability improvement, digital transformation and AI solutions for clients across several industries, with a particular focus on the healthcare payer segment. The firm advises U.S. health plans across lines of business, including Medicaid, Medicare, ACA Marketplace and commercial, helping clients manage the total cost of care and expand affordability without sacrificing quality or the member experience. In 2025, AArete secured a strategic investment from Parthenon Capital, a growth-oriented private equity firm with deep experience backing healthcare solutions and technology companies, further strengthening the firm's continued growth. "What we've built at AArete would not be possible without a culture built on integrity, excellence and care for the people we serve, and I'm proud that Pam will continue that legacy," Trimble said. "She's a purpose-driven leader whose passion for people and delivering results for clients reflects the values of the firm. I am confident she will lead AArete into its next chapter and build on the firm's success." Trimble established AArete in 2008 with the goal of building a consulting firm that nurtures long-term client partnerships. Under his leadership, AArete grew into a global firm with more than 500 team members, earning recognition as a Forbes World's Best Management Consulting Firm for four consecutive years and a USA Today Top Workplaces Award, underscoring the firm's strong culture and people-first approach. "AArete has become an essential partner to many of the nation's leading health plans, and Pam is exactly the right leader to build on the firm's momentum going forward," said Dan Killeen, partner at Parthenon Capital. "Her payer expertise and track record of driving growth and performance make her uniquely suited to lead AArete into the future. We are grateful to Loren for his visionary leadership and look forward to his continued engagement as a member of the board." About AArete AArete is a global tech-forward management consulting firm specializing in driving profitability improvement, digital transformation, and strategy & change for clients. AArete's solutions are powered by a digital-first mindset, market intelligence and data-driven approach to deliver purposeful change, actionable insights and guaranteed results. AArete humanizes data by translating numbers into actionable insights, helping clients make better decisions and standing by their side to foster change with confidence, empathy and purpose. For more information, visit aarete.com.

AArete
Jul 22nd, 2026
AArete signals next phase of growth with key leadership appointments.

AArete signals next phase of growth with key leadership appointments. New leaders strengthen strategy, corporate development and clinical intelligence capabilities to deliver additional value for clients CHICAGO-(BUSINESS WIRE)-AArete, a leading global tech-forward consulting firm, today announced the appointments of Jeff Berger as vice president, strategy and corporate development, and Dr. Danielle Smith as vice president, clinical intelligence. These strategic additions reflect AArete's continued investment in leadership, innovation and specialized expertise as the firm advances its next phase of growth. "Jeff and Danielle will be great additions to the leadership of our growing firm," said Loren Trimble, chief executive officer of AArete. "They are accomplished leaders with proven track records of driving transformation, accelerating growth and delivering results. Their appointments reinforce our commitment to serving clients at the highest level with healthcare innovation as we position the firm for continued success." Jeff and Danielle's appointments reinforce our commitment to serving clients at the highest level with healthcare innovation as we position the firm for continued success. Loren Trimble, CEO Advancing firm strategy and growth. As vice president, strategy and corporate development, Berger serves as a strategic partner to AArete's executive leadership team, helping define firm-wide priorities and translate strategy into action. He leads the firm's corporate development initiatives, including merger and acquisition strategy, due diligence and post-merger integration. Berger brings more than 20 years of experience in strategy, corporate development and operational excellence. Prior to joining AArete, he spent two decades at Protiviti, where he partnered with executive leadership to advance enterprise strategy, organizational effectiveness and growth initiatives. Berger holds a master's degree in business administration from the University of Chicago Booth School of Business and a bachelor's degree in accounting from the Indiana University Kelley School of Business. He is a certified public accountant (CPA) and a Six Sigma Green Belt certified by the American Society for Quality. Expanding clinical intelligence capabilities. As vice president, clinical intelligence, Smith helps expand AArete's clinical intelligence capabilities across several strategic solution areas. Her expertise spans clinical operations, medical management, utilization management, clinical policy and government-sponsored healthcare programs. With more than 20 years of experience in healthcare and managed care, Smith has deep expertise in advancing healthcare quality, patient safety, clinical efficiency and value-based outcomes. Throughout her career, Smith has served as a transformational leader focused on quality improvement, operational excellence and healthcare innovation. Her previous leadership roles include vice president at Redwood Management Inc., national medical director for clinical policy at Molina Healthcare and program medical director/chief hospitalist at Sound Physicians. Smith earned a master's degree in business administration from the University of Wisconsin-Whitewater, a medical degree from the Medical College of Wisconsin and a bachelor's degree from the University of Wisconsin-La Crosse. She also holds a Lean Six Sigma certification and Six Sigma Black Belt from Villanova University. "We are fortunate to have Danielle and Jeff join our team. These leadership appointments represent another important milestone in AArete's growth journey," added Trimble. "As organizations face increasing complexity and pressure to transform, we are investing in the talent and capabilities required to help them navigate change, unlock value and achieve results."