Healthcare Analytics – Payor/Provider Finance Data and AI, Managed Care Contracting – Optimization

Role Overview

• The Healthcare Finance Data and AI team translates healthcare data into measurable healthcare financial performance.
• This role is dedicated to managed care contracting.
• Learn to read payer contracts (commercial and government).
• Model reimbursement terms in existing tools and enhance those tools with automation using SQL and Python.
• Partner with contracting, revenue integrity, and patient financial services teams to ensure modeled rates and rules align with contract language and adjudication behavior.
• Turn findings into clear, executive-ready recommendations.
• Learn and interpret payer contracts.
• Validate modeled results by reconciling remittance advice and historical payments; investigate and resolve discrepancies with root cause analysis.
• Maintain a controlled library of contract models.
• Build/optimize ETL/ELT pipelines to ingest fee schedules and contract artifacts; implement QA/validation checks.
• Use advanced SQL to automate contract lookups, grouper logic, case mix normalization, and variance analytics.
• Use Python for parsing artifacts, applying calculation engines, regression/variance checks, and generating validation reports.
• Develop Power BI/Tableau dashboards for contract performance.
• Own analytics workstreams; present findings that connect contract mechanics to RCM KPIs.
• Work with Managed Care/Finance, Revenue Integrity/CDM, PFS, and IT/Data teams to align interpretation, data sources, and operationalization.
• Support pursuits showcasing contract modeling capabilities and automation.
• Enhance contract modeling tooling and contribute reusable assets.

Requirements

• Bachelor's degree is required
• Minimum ONE (1) year of experience in healthcare analytics, consulting, or adjacent healthcare services with measurable data driven outcomes (revenue cycle management exposure strongly preferred)
• Experience building production-grade ETL/ELT processes and implementing data quality frameworks
• Proficiency with BI/visualization tools (Power BI or Tableau) and strong Excel skills
• Excellent communication—able to translate technical and contractual details into concise, executive-ready insights
• Detail oriented, self-directed, collaborative teammate comfortable leading workstreams

Tech Stack

• ETL
• Python
• SQL
• Tableau

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave and Adoption Assistance
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Student Loan PayDown
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program
• Mobility Stipend