Manager, Solution Specialist, Payment Intelligence

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