Business Analytics Senior Manager Payment Integrity - Risk & Affordability

The role involves leading a team of analysts supporting Payment Integrity initiatives within a healthcare organization, focusing on data analytics, AI, financial insight, and leadership to improve healthcare affordability and outcomes.

Location: United States

Salary: $130,900–$218,100 USD/year, plus potential bonus

Responsibilities

• Lead strategic analytics to identify medical cost drivers, trends, risks, and opportunities.
• Develop and execute analysis and AI to support Payment Integrity strategies and align across business units.
• Translate analytical findings into clear insights for executive decision-making.
• Own financial business cases for new initiatives, including forecasts and performance analysis.
• Support analytics for policy changes and performance monitoring.
• Enhance reporting and visualization capabilities using AI and tools like Databricks, Tableau.
• Modernize analytics through automation and AI-enabled tools.
• Research industry trends and advise senior management on strategy.
• Manage and develop a team of analysts, prioritize initiatives, and ensure data quality.
• Act as a trusted partner to senior leaders, providing insights on affordability strategies.

Requirements

• Bachelor’s degree or higher in Economics, Finance, Data Science, Analytics, Business, Public Health, Actuarial Science, or similar; Master’s preferred.
• 7+ years of experience in predictive analytics, financial modeling, healthcare economics, or related fields, with leadership experience.
• Strong skills in SQL, Excel, SAS, Databricks, Tableau, or similar platforms.
• Knowledge of medical claim coding and provider reimbursement.

Benefits

• Comprehensive health benefits including medical, vision, dental, and behavioral health.
• 401(k) plan, paid time off, holidays, life insurance, tuition reimbursement.
• Annual bonus eligibility.

Additional Information

• Remote work possible with internet speed requirements.
• Salary range is $130,900–$218,100 USD/year, depending on experience and location.
• The organization is committed to diversity and inclusion, with policies on tobacco use and criminal history considerations.