The Security Analyst will manage security assurance operations, including triaging security requests, responding to customer questionnaires, and maintaining security documentation. They will also support audit preparation for frameworks like HITRUST and SOC 2 while assisting with vendor risk assessments and security metrics tracking.
The Client Liaison coordinates cross-functional teams to drive revenue retention, client satisfaction, and growth within the Payment Integrity product suite. They serve as the primary point of contact, managing operational execution, performance monitoring, and strategic client initiatives.
Develop and advance machine learning models to identify and audit healthcare claims for errors and fraud. Create technical frameworks and tools to improve data pipelines and enhance team modeling capabilities.
Lead the design and development of large-scale AI systems to automate document processing and healthcare claim validation. Collaborate with cross-functional teams to evolve agentic workflows and ensure system reliability and scalability.
You will lead the engineering team in designing and evolving the enterprise data warehouse, including building governed metrics and reliable operational pipelines. You will also manage engineers and analysts while partnering with product teams to shape technical architecture and delivery standards.
You will set the technical direction for backend systems and build scalable, cloud-native services to support payment-integrity decisions. You will also mentor engineers, collaborate cross-functionally, and integrate AI-driven workflows into the development process.
The DRG Dispute Reviewer evaluates provider appeals and original audit findings to ensure accurate DRG assignment and payment outcomes. This role involves analyzing inpatient medical records and preparing evidence-based rationales to support audit determinations.
You will manage the pharmacy claim recovery process by collaborating with payers to enhance reconciliation and developing process improvements. Additionally, you will be responsible for generating team reports and maintaining comprehensive process documentation.
You will optimize complex T-SQL queries and database performance to handle multi-terabyte claims datasets efficiently. Additionally, you will perform root-cause analysis on data anomalies and develop automated tools to enhance data mining capabilities.
You will serve as the end-to-end technical owner for client migrations, managing the full lifecycle from legacy system analysis to production deployment. This involves architecting migration pipelines, reverse-engineering complex legacy logic, and orchestrating collaboration across multiple internal teams.
Design, build, and operate end-to-end data pipelines and models for health plan data, including ingestion, quality, deployment, and ongoing operations. Migrate legacy processes to a shared platform and extend tools and workflows for reuse by partner teams.
The DRG QA and Trainer is responsible for auditing the work of DRG Reviewers to ensure clinical and coding accuracy while providing constructive feedback. They also collaborate with educators to conduct training sessions and develop resources to support team performance and continuous improvement.
The Senior Healthcare Data Analyst will design and implement data transformations for medical claims while driving payment integrity insights using AI-assisted workflows. They will also serve as a subject matter expert, collaborating with cross-functional teams to ensure accurate, scalable data solutions.
The Implementation Manager leads end-to-end implementation cycles for healthcare technology and payment integrity solutions, serving as the primary point of contact for clients. This role manages cross-functional teams, project timelines, and data integrations to ensure high-quality delivery and measurable value.
Conduct comprehensive pre and post pay claims audits to ensure compliance with regulatory requirements and payment guidelines. Assist in product testing, quality enhancements, and serve as a subject matter expert for internal teams.
The Medical Review Nurse II performs retrospective and prepayment audits on skilled nursing facility medical claims to ensure medical appropriateness. They also document findings, generate audit reports, and support the appeals process while collaborating with clients and internal teams.
Develop, maintain, test, and optimize payment integrity audit concepts for durable medical equipment, home health, and home infusion claims, ensuring alignment with coding standards, payer policies, and regulatory requirements. Support audit operations through policy guidance, training, analytics, client collaboration, quality assurance, and workflow improvements.
Audit inpatient and outpatient medical claims for commercial and government payers, document findings using applicable policies and guidelines, and support appeals when needed. Collaborate on audit improvements, medical policies, provider education, quality assurance, training, and development of review guidelines and system edits.
The Senior Analyst will lead the development of new reimbursement and payment integrity concepts by analyzing claims data and provider contracts. They will collaborate with engineering and data science teams to translate complex business logic into effective analytical and automation frameworks.
The analyst is responsible for developing, validating, and maintaining clinical and coding audit concepts to ensure payment integrity. They collaborate with cross-functional teams to interpret regulatory changes and payer policies while leveraging AI tools to optimize audit performance.
You will design, validate, and maintain clinical and coding content for healthcare payment editing products with a focus on New York State Medicaid. The role involves collaborating with product and data science teams to translate complex reimbursement policies into testable editing logic.
The role involves sourcing, designing, and maintaining clinical and coding content for specialty pharmacy and high-cost drug editing products. You will collaborate with product and data science teams to validate content using claims data and ensure accurate, defensible payment integrity outcomes.
Perform medical claims audit reviews for government clients by applying appropriate medical review guidelines and policies. Document findings, generate audit letters, and support findings during the appeals process while collaborating with the audit team.
You will redesign data layers for AI products and build a robust Rust framework to improve service performance and correctness. Additionally, you will drive the adoption of AI tools across the company and improve observability and resilience across the platform.
The Leave of Absence Manager owns the end-to-end administration of all employee leave programs, including FMLA, ADA accommodations, and state-specific leaves. Additionally, the role provides cross-functional support to the benefits team for health, welfare, and retirement plan administration.
The Assistant General Counsel will own the drafting and negotiation of AI, data, and IP terms within commercial agreements. They will partner with Sales and Client Success teams to ensure contract terms align with product architecture and regulatory requirements.
The Product Marketing Manager will develop foundational messaging, positioning, and value propositions while supporting product launches and sales enablement. They will also create core marketing assets and translate complex AI-powered healthcare capabilities into clear, compelling narratives for diverse payer audiences.
Lead the DRG team and manage clinical claims review, including DRG validation, readmissions, and place-of-service reviews. Develop and improve clinical solutions, policies, workflows, and reporting while coordinating with clients and cross-functional teams to identify and correct claims issues.
You will own the analytics layer by modeling complex healthcare operational data into certified dimensional models and building governed semantic layers. Additionally, you will manage visualization dashboards, data observability, and orchestration workflows to ensure business leaders have accurate, actionable metrics.
The Senior Product Designer will leverage design thinking to create innovative solutions and conduct user research to inform product development. They will also collaborate with cross-functional teams to produce wireframes, prototypes, and design specifications while maintaining design systems.
