The role involves auditing hospital claims, identifying billing errors and DRG misassignments, and negotiating with claims administrators to secure recoveries. The reviewer will also serve as a subject matter expert for ASO clients, managing high-cost claims and ensuring compliance with plan documents and contracts.
Design and build fullstack web applications and APIs to process complex healthcare data. Deploy and optimize scalable, secure solutions on Azure and Kubernetes while collaborating in an agile environment.
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.
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 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 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.
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.
