We are seeking a Manager, Solution Specialist, Payment Intelligence to lead client engagements focused on claims analytics, overpayment identification, and post-pay data mining strategies. The Manager will oversee a team of analysts and consultants to design and implement solutions that improve claims payment accuracy and operational efficiency.
Requirements
- 7+ years of experience in payment integrity, healthcare analytics, or payer operations with a Bachelor’s Degree, or 10+ years of equivalent experience without a degree
- Comprehensive understanding of healthcare claims and reimbursement methodologies across Medicare, Medicaid, ACA/Marketplace, Commercial, and Duals
- Demonstrated experience managing analytics or consulting teams delivering payment integrity or cost containment solutions
- Proficiency in claims data analytics and identification of mispaid claims to ensure accuracy and compliance
- Strong communication, presentation, and stakeholder management skills
- Advanced proficiency in Microsoft Excel or working knowledge of SQL or other query languages
- Strong analytical, problem-solving, and storytelling abilities to translate complex data into actionable recommendations
Benefits
- Flexible PTO
- Monthly half-day refuels
- Volunteer time off
- 10 paid holidays
- Own Your Day flexible work policy
- Competitive majority employer-paid benefits: Medical, Dental, Vision, 401K Match
- Generous paid parental leave options
- Employer paid Life Insurance, STD, LTD
- Charitable contribution matching program
- New client commission opportunities and referral bonus program
- Bike share discount program