Senior Medical Cost Analytics Advisor

Jobtailor; Deutschland; Vor Ort; EUR 90.000 - 140.000; Vollzeit

Zusammenfassung

Jobtailor is seeking a senior analytics professional to support the Payment Integrity team in Germany. You will drive strategy, perform advanced cost analytics, and translate complex results into executive-ready insights to influence the strategic roadmap.

You will own financial impact assessments, build dashboards, and partner across functions to identify savings and improve data quality. Required are 8+ years in medical cost analytics or related fields, strong SQL/Excel/SAS/Tableau skills, and

Qualifikationen

• Bachelor’s degree in a quantitative field such as Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, or Applied Mathematics, or equivalent experience.
• 8+ years of progressive experience in medical cost analytics, payment integrity, financial modeling, or related fields.
• Strong analytical and technical skills.
• Hands-on experience with SQL, Excel, SAS, Tableau, Databricks, or similar platforms.
• Knowledge of reimbursement methodologies and coding, including MS-DRG, APCs, HCPCs, and RBRVS.
• Familiarity with professional and facility claim constructs.
• Experience working in regulated and compliance-aware environments.
• Experience modernizing analytics through automation and AI-enabled or advanced analytics methods, such as predictive modeling, NLP, and machine learning.
• Ability to translate complex analyses into actionable business insights for senior and executive audiences.
• Strong collaboration and influence skills in a matrixed environment.
• Self-starter orientation toward continuous improvement, ownership, and impact.
• For occasional or permanent home working, cable broadband or fiber optic internet with at least 10 Mbps download and 5 Mbps upload is required.

Aufgaben

• Provide strategy and analytical support for the Payment Integrity team.
• Evaluate pre-payment and post-payment editing, clinical coding audits, and recovery programs.
• Translate payment integrity program performance and results into actionable insights and business cases.
• Identify and size new savings opportunities.
• Identify trends, risks, and affordability opportunities across cost containment and payment integrity programs.
• Translate complex findings into executive-ready insights and support the strategic roadmap.
• Own financial impact assessments and business cases, including forecasts, variance analysis, and performance recommendations.
• Support program measurement and performance monitoring through dashboards, scorecards, and executive materials.
• Assess billing patterns, coding and reimbursement dynamics, and drivers of wasteful or abusive practices.
• Partner across finance, operations, clinical, network, claims, product, vendor, contracting, coverage policy, compliance, reserving, and analytics teams.
• Support vendor evaluation and sourcing through analysis of negotiations, pricing structures, and performance guarantees.
• Improve data quality, strengthen controls, and enable scalable self-service analytics through automation and AI-enabled tools.

Kenntnisse

SQL

Financial Modeling

Payment Integrity

Data Analytics

Predictive Modeling

NLP

Machine Learning

Data Analysis

Variance Analysis

Dashboard Development

Reimbursement Methodologies

Automation

Data Quality

Excel

SAS

Tableau

Databricks

Ausbildung

Bachelor’s degree in a quantitative field

Tools

SQL

Excel

SAS

Tableau

Databricks

AI-Enabled Tools

Jobbeschreibung

• Provide strategy and analytical support for the Payment Integrity team.
• Evaluate pre-payment and post-payment editing, clinical coding audits, and recovery programs.
• Translate payment integrity program performance and results into actionable insights and business cases.
• Identify and size new savings opportunities.
• Identify trends, risks, and affordability opportunities across cost containment and payment integrity programs.
• Translate complex findings into executive-ready insights and support the strategic roadmap.
• Own financial impact assessments and business cases, including forecasts, variance analysis, and performance recommendations.
• Support program measurement and performance monitoring through dashboards, scorecards, and executive materials.
• Assess billing patterns, coding and reimbursement dynamics, and drivers of wasteful or abusive practices.
• Partner across finance, operations, clinical, network, claims, product, vendor, contracting, coverage policy, compliance, reserving, and analytics teams.
• Support vendor evaluation and sourcing through analysis of negotiations, pricing structures, and performance guarantees.
• Improve data quality, strengthen controls, and enable scalable self-service analytics through automation and AI-enabled tools.

Requirements

• Bachelor’s degree in a quantitative field such as Economics, Finance, Data Science, Data Analytics, Actuarial Science, Business, Public Health, or Applied Mathematics, or equivalent experience.
• 8+ years of progressive experience in medical cost analytics, payment integrity, financial modeling, or related fields.
• Strong analytical and technical skills.
• Hands-on experience with SQL, Excel, SAS, Tableau, Databricks, or similar platforms.
• Knowledge of reimbursement methodologies and coding, including MS-DRG, APCs, HCPCs, and RBRVS.
• Familiarity with professional and facility claim constructs.
• Experience working in regulated and compliance-aware environments.
• Experience modernizing analytics through automation and AI-enabled or advanced analytics methods, such as predictive modeling, NLP, and machine learning.
• Ability to translate complex analyses into actionable business insights for senior and executive audiences.
• Strong collaboration and influence skills in a matrixed environment.
• Self-starter orientation toward continuous improvement, ownership, and impact.
• For occasional or permanent home working, cable broadband or fiber optic internet with at least 10 Mbps download and 5 Mbps upload is required.

Core Competencies

Demonstrates expertise in payment integrity and medical cost analytics, with a strong focus on financial modeling, data analysis, and the ability to translate complex findings into actionable insights for executive decision-making. Proficient in utilizing advanced analytics methods and tools to enhance program performance and drive cost containment strategies.

Highest-signal resume keywords

• SQL
• Financial Modeling
• Payment Integrity
• Data Analytics
• Predictive Modeling

ATS Optimization Keywords

Hard Skills

• Data Analysis
• Financial Impact Assessment
• Variance Analysis
• Clinical Coding Audits
• Cost Containment Strategies
• Reimbursement Methodologies
• Automation
• Machine Learning
• NLP
• Dashboard Development

Soft Skills

• Collaboration
• Influence
• Self-Starter Orientation
• Continuous Improvement
• Communication

Industry Keywords

• Healthcare Analytics
• Regulated Environments
• MS-DRG
• APCs
• HCPCs
• RBRVS
• Billing Patterns
• Cost Containment
• Vendor Evaluation
• Performance Monitoring

Tools & Technologies

• Excel
• SAS
• Tableau
• Databricks
• AI-Enabled Tools