The Senior Lead of Payment Integrity manages end-to-end carrier network performance, satisfaction, and operational excellence. They act as the primary liaison between carriers and internal teams to drive transparency, process improvements, and data-informed decision-making.
The Director of Managed Care Pharmacy Analytics serves as the primary clinical subject-matter expert for client-facing interactions and PBM RFP evaluations. They also partner with data science teams to validate clinical logic and ensure payment integrity models align with operational and regulatory standards.
You will design, build, and maintain automated regression suites for internal tools, APIs, and portals while integrating them into CI/CD pipelines. Additionally, you will apply AI-enabled testing tools to accelerate test generation and act as the primary release quality gate.
The Business Analyst will manage Jira workflows and documentation for data science and analytics teams to improve operational efficiency. They will also own the prioritization process for data science models, ensuring clear communication between technical teams and stakeholders.
The Senior Claims Analyst will audit hospital bills and claims data to identify billing errors, coding discrepancies, and overpayment opportunities. They will also serve as a client advocate, negotiating with claims administrators to secure adjustments and recoveries for ASO clients.
The role involves migrating legacy SQL Server logic to a modern Snowflake data platform while building governed data marts. You will also develop dashboards in Sigma and partner with business stakeholders to ensure accurate, decision-ready reporting.
Design, build, and maintain data ingestion pipelines and transformation models within a Snowflake warehouse. Collaborate with stakeholders to translate business requirements into governed data structures and reliable reporting metrics.
The Director of Account Management will serve as the primary point of contact for self-insured employer clients, providing strategic healthcare data analytics solutions. This role involves leading client relationships, managing internal cross-functional teams, and translating complex data insights into actionable business strategies.
