Lead complex healthcare claims data initiatives by designing scalable SQL-based data models and automation frameworks. Translate disparate claims data into high-performance analytics to support product and business objectives with high autonomy.
SmartLight Analytics
10 Remote Job Openings at SmartLight Analytics
The Director oversees the performance and accuracy of the Claims Administrators network, focusing on payment operations and quality assurance. This role involves leading carrier engagement initiatives and providing analytical data insights during business reviews with clients and carriers.
Lead strategic relationships with self-insured employer clients to deliver high-quality healthcare data analytics solutions. Translate complex data insights into actionable strategies and manage internal resources to ensure timely project delivery.
The role involves designing and executing automated and manual tests for web applications, APIs, and databases to identify and track defects. The analyst will build automation suites using Selenium and Python while collaborating with engineering teams to define test strategies.
Lead Pharmacy Payment Integrity Analyst
SmartLight Analytics
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Full Time
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25 days ago
SmartLight Analytics
The analyst identifies improper pharmacy billing activities and overpayments by reviewing claims data and utilizing AI and predictive analytics. They are responsible for documenting actionable findings and resolving data discrepancies to optimize healthcare payments.
The Manager of Carrier Engagement evaluates payment integrity processes related to carrier reimbursements and partners with stakeholders to improve outcomes and efficiency. This role also leads and mentors the department’s Clinical Analysts while providing clinical expertise to support operational workflows.
The Senior Lead of Payment Integrity is responsible for managing the performance and operational excellence of the company's carrier network. This includes developing strategic relationships, overseeing payment operations, and driving continuous improvement initiatives.
Lead the modernization of data infrastructure by building ETL pipelines and warehouse models in Snowflake. Partner with the SQL Server team to migrate legacy systems to the cloud while ensuring strict security for healthcare data.
Healthcare Statistical Data Scientist
SmartLight Analytics
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Full Time
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a month ago
SmartLight Analytics
Design and deploy machine learning models to analyze healthcare claims data for cost prediction, fraud detection, and risk adjustment. Collaborate with clinicians and product teams to transform complex datasets into actionable operational insights.
The RFP Manager will lead the end-to-end coordination and execution of RFPs, RFIs, and security assessments for healthcare enterprise clients. They will also support existing client relationships by creating tailored proposal materials and collaborating with cross-functional teams to ensure messaging consistency.
